OPHTE#I-i-5-32M Harnett County Department of Public Health 23190
PERMIT # 7 7 "7 Y Operation Per
/New Installation - Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: l
Name: (owner) -J—OA'wjr a G Si , , -' SUBDIVISION —� LOT #
System Installer: Ly ';7�' Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms
Type of Water Supply: ❑ Community Z Public ❑ Well Distance from well feet
System Type: C'A?y 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.
MIS system has been installed in compliance with applicable North Lam= beneral matutes, rules for sewage treatment ana uispo<.at, ana an conamons of me Improvement rermn ana !onstrucuon HucnonZNIOH.
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PERMIT CONDITIONS:
I. Perfor e:
II. nitoring:
III. J aintenance:
IV. Operation:
V. Other:
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ot Y., rr
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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 ❑
Following are the spec atlons for the sewage disposal system on the above captioned property.
Type of system: Conventional ❑ Other
Subsurface No. of exact length
Drainage Field ditches L of each ditch feet
French Drain Required: Linear feet
Alarm ❑
1-12O1-ine ❑
PWR Line
Septic Tank: 10b.0 gallons Pump Tank: gallons
width of depth of
ditches feet ditches z_ inches
Authorized State Agefi '� _ 'w Date
14 -5- 32798(1)
14 -5- 32798(2)
14 -5 -32798 (3)
14 -5 -32798 (4)
14 -5 -32798 (5)
14 -5 -32798 (6)
14 -5 -32798 (7)
14 -5 -32798 (8)
14 -5 -32798 (9)
14 -5 -32798 (11)
14 -5 -32798 (12)
14 -5- 32798(13)
14 -5 -32798 (14)
14 -5 -32798 (10)