OP RHTE# ICO-5-~;")550-- Harnett County Department of Public Health 21 5 0 4
PERMIT # 2-68 Operation Permit
New Installation `1k, Septic Tank El Repair ~ Nitrification Line 11 Expansion
PROPERTY LOCATION: N C,~~
Name: (owner) g 3c _ SUBDIVISION E-pg~ 'S M LOT # S
System Installer: Lc--z" y+~~G Registration #
Basement with plumbing: ❑ Garage ❑ *vm of 4 Bedre w S raapoN SC.Aou>~
Type of Water Supply: ❑ Community ❑ Public ❑ Well Distance from well feet
System Type: h 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.
ims system nas peen mstanea in
with applicable north 6arohna General Statutes, Rules for Sewage Treatment and Disposal and all conditions of the Improvement Permit and Construction Authorization
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1. 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:
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional 'S~ Other 1 a.G G\-\ Nns Septic Tank: 50~ gallons Pump Tank: gallons
Subsurface No of exact length width of depth of
Drainage Field ditches 3 _ of each ditch a C> feet ditches 3 feet ditches -1-0-30 inches
French Drain Required: \
Authorized State Agent Date ~-l ~4 1 &
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This load of tire chips is from the Fuel Grade location and meats the Nc spec"Icailott as
sty< +n tnnovotl o '01r te;,c,sr Systam approval IWWS-2002-038 fot fit* chip
Substitution far Rock AgVegrafe In NBr OIlon fields,
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