OPHTE# �$ - ° 50 L1r Harnett County Department of Public Health 23197
PERMIT # 7 -7,2 '3 Operation Permit
LJ New Installation CT' Septic Tank Nitrification line ❑ Repair ❑ Expansion
PROPERTY LOCATION: t�6 � D
Name: (owner) Cc 446n) SUBDIVISION LOT #
System Installer: fs� Registration #
Basement with plumbing: ❑ 4arage ❑ liumber of Bedrooms �-1
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: Types V and VI Systems expire in 5 years.
(In accordance with Table V a) ner must cont t Health Department 6 months prior to expiration for permit renewal.
This system has been installed in cam ' ce with applicable North Carolina General Statutes Rules for Sewage Treatment and Dispas 1 conditions of the Improvement Permit and Construction Authorization.
PERMIT CONDITIONS:
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
LVAI
I
t
t at
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.
IN
K
❑ D -Box ❑ Pump ❑ Alarm ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sews a disposal system on the above captioned property.
Type of system: ❑ Conventional Y Other ZS-01a RA9 ;ft Septic Tank: ` .Cr& gallons Pump Tank: _ gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch & feet ditches feet ditches inches
French Drain Required: Linear feet
Authorized State Age
Date r`�� _ � I
14 -5 -33049 (10)
14 -5 -33049 (9)
14 -5 -33049 (8)
14 -5 -33049 (7)
14 -5 -33049 (6)
14 -5 -33049 (5)
14 -5- 33049(4)
14 -5 -33049 (3)
14 -5 -33049 (2)
14 -5 -33049 (1)