OPHTE# TZ Harnett County Department of Public Health
PERMIT # Z7Z36 Operation Permit 22984
C7 New Installation Septic Tank ❑'I�'Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: T7t.iy32 13QL -1�1 B
Name: (owner) SUBDIVISION 1_ P 7— LOT # 7
System Installer: Registration #
Basement with plumbing: ❑ Garage 2'-Number of Bedrooms
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: Z S % KXbu L ea,& nic 6- r.Z Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with aoDlicable North Carolina General Statutes. Rules far Sewave Treatment and Disposal. and all conditions of the Imnrnvement Parmit and rmtnirtinn Anthnri72tinn
rtKMII UJNUIIIUNI:
I. Performance:
Il. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR line
Following are the specifications for the sews disposal system on the above captioned property.
Type of system: ❑ Conventional Other LS?, iZF.Mcn6�,) N,Ag _, Septic Tank: /Do d gallons Pump Tank: gallons
Subsurface No. of exact length t width of 3 depth of
Drainage Field ditches 3 of each ditch `�a feet ditches feet ditches Zb —1$ inches
French Drain Required: Linear feet
Authorized State Ate-nit Date L° — I`i — 13
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rtKMII UJNUIIIUNI:
I. Performance:
Il. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR line
Following are the specifications for the sews disposal system on the above captioned property.
Type of system: ❑ Conventional Other LS?, iZF.Mcn6�,) N,Ag _, Septic Tank: /Do d gallons Pump Tank: gallons
Subsurface No. of exact length t width of 3 depth of
Drainage Field ditches 3 of each ditch `�a feet ditches feet ditches Zb —1$ inches
French Drain Required: Linear feet
Authorized State Ate-nit Date L° — I`i — 13
12 -5 -30207 (1)
12 -5 -30207 (2)
12 -5 -30207 (3)
12 -5 -30207 (4) 12 -5 -30207 (5)
12 -5 -30207 (6)
12 -5 -30207 (7)
12 -5 -30207 (8)
12 -5 -30207 (9)