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OPHTE# 1Z--5- - -30jZ1 Harnett County Department of Public Health PERMIT # Z7 ` 1-� ODeration_ Permit 22973 2--New 'Installation 12"'Septic Tank 2"'Nitrification Line ❑ Repair ❑ Expansion PROPERTY LOCATION: 5yw4i 8 (_ Name: (owner) .5r SUBDIVISION LOT # _ System Installer: )A&4b A-Af 4; - —np Registration # Basement with plumbing: ❑ Garage N ber ofBedrropms `r Type of Water Supply: ❑ Community © Public 2 Well Distance from well feet System Type: Pljes -r, 40 z- t"Z�`s_ y et 0 u"7 Types V and VI Systems expire in 5 years. (In accordance with V a) Owner must contact Health Department 6 months prior to expiration for permit renewal. PERMIT CONDITIONS: I. Performance: System shall perform in accordance with Rule .1961. 11. Monitoring: As required by Rule .1961. III. Maintenance: As required by Rule .1961. Other: Subsurface system operator required? Yes ❑ No ❑ If yes, see attached sheet for additional operation conditions, maintenance and reporting. IV. Operation: V. Other: ❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line Following are the specifications for the sewap disposal system on the above captioned property. Type of system: ❑ Conventional X Other 6 �4 0 Septic Tank: JZ gallons Pump Tank: gallons Subsurface No. of exact length width of depth of ��pp Drainage Field ditches of each ditch 1 �� feet ditches feet ditches z7 inches French Drain Required: Linear feet ot Authorized State Age Date Z 12 -5 -30124 (1) 12 -5 -30124 (2) 12 -5 -30124 (3) 12 -5 -30124 (4) 12 -5 -30124 (5) 12 -5 -30124 (6) 12 -5 -30124 (7) 12 -5 -30124 (8) 12 -5 -30124 (9) 12 -5 -30124 (11) 12 -5 -30124 (12) 12 -5 -30124 (13) 12 -5 -30124 (14) 12 -5 -30124 (10)