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OPHTE# t3- 0 Harnett County Department of Public Health 23142 PERMIT # a��1`� Operation Permit New Installation Septic Tank Nitrification Line ❑ Repair ❑ Expansion �^ PROPERTY LOCATION: C)OGS 9-D Name: (owner) 1 t } 1 � -5 -y 2V C`\ O tom► SUBDIVISION C) Ny.,00ts—N LOT # 15 G System Installer: �x s 5,Nnoc --'* P,,ND Registration # Basement with plumbing: ❑ Garage Number of Bedrooms Type of Water Supply: ❑ Community Public ❑ Well Distance from well 1- ©0 feet System Type: D 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 rtRMll LUNUiIIUNS: I. Performance: II. Monitoring: Ill. Maintenance: IV. Operation: V. Other: L P-1 (� 95) 17E �i ® 2 F T� 37' � y CW ERIL-/ U T L..L O zN v r- 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 cc maintenance and reporting. ❑ D -Box ❑ Pump ❑ Alarm ❑ 1-12O1-ine ❑ PWR Line Following are the specifications for the ewage disposal system on the above captioned property. Type of system: El Conventional Other E Z V: Ow Septic Tank: 1 D4 gallons Pump Tank: 1 ©00 gallons Subsurface No. of exact length width of depth of Drainage Field ditches �-a of each ditch � S feet ditches 3 feet ditches Q14 inches French Drain Required: �'—,I.inear feet Authorized State Agent N ' -N e_6 )13 Date al 18 1x-15-- x140)