OP RHTE# 1 Harnett County Department of Public Health 23136
PERMIT # ����� Operation Permit
l New Installation 'J�4, Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: �� �low1 osv
Name: (owner) N \1 j �orne.s LI--C -- SUBDIVISION 'i*�\ LOT # Q, S-�'\
System Installer: �— ') \,-A �C_ Registration #
Basement with plumbing: El Garage Number of Bedrooms t-4
Type of Water Supply: ❑ Community Public ❑ Well Distance from well VC) 0 feet
System Type: - Z.i_\0 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 applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
rCnrlll LUNUIIIUNS:
I. Performance: System shall perform in accordance with Rule .1961.
II. Monitoring: As required by Rule .1961.
111. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ NOA
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 sewage disposal systern w the above ,ca_ptioned property.
Type of system: El Conventional X Other Rum4 '10 — -2 ¢LCJ-\ i Septic Tank: 10 0 0 gallons Pump Tank: 01�) gallons
Subsurface No. of exact length _ width of depth of
Drainage Field '—ditckg of each ditch 7 S feet ditches feet ditches ) inches
French Drain Required: Linear feet
Authorized State Agent - ``�. -� �"
Date _}