OP- have not purchased permits per VC can not sign off in HTEHTE # 8 Harnett County Department of Public Health
PERMIT # 2-77cS Operation Permit 23014
New Installation Septic Tank IZ Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:
Name: (owner) SUBDIVISION LOT #
System Installer: _I Registration #
Basement with plumbing: ❑ Garage ❑� Number of Bedrooms 5
Type of Water Supply: ❑ Community Z" Public ❑ Well Distance from well feet
System Type: '�"� "!- d G- 47 es 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 applicable North
PERMIT CONDITIONS:
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
all conditions of the Improvement Permit and Construction Authorization.
NA
System shall perform in accordance with Rule .1961. %
As required by Rule .1961. G
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 sewage disposal system on the above captioned property.
Type of system: El Conventional L'i Other 2s ', - W 'Sys i Septic Tank: 1 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch 0 Z'C feet ditches 3 feet ditches inches
French Drain Reouired: Linear feet
Authorized State A¢ent,r _ Date
PL
r
216
NA
System shall perform in accordance with Rule .1961. %
As required by Rule .1961. G
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 sewage disposal system on the above captioned property.
Type of system: El Conventional L'i Other 2s ', - W 'Sys i Septic Tank: 1 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch 0 Z'C feet ditches 3 feet ditches inches
French Drain Reouired: Linear feet
Authorized State A¢ent,r _ Date
13 -5 -31445 (1)
13 -5 -31445 (2)
13 -5 -31445 (3)
13 -5 -31445 (4)
13 -5 -31445 (5)
13 -5 -31445 (6)
13 -5 -31445 (7)
13 -5 -31445 (11) 13 -5 -31445 (12)
13 -5 -31445 (8)
13 -5 -31445 (9)
13 -5 -31445 (10)