OPHTE# 1,4 �s z Harnett County Department of Public Health 23195
PERMIT # / Operation PPerwit ,/�
® New Installation Li( Septic Tank C7' Nitrification line ❑ Repair ❑ Expansion
PROPERTY LOCATION: Mej 06 c
Name: (owner) - .vl- SUBDIVISION ; ., LOT # 14
System Installer: p fs Registration #
Basement with plumbing: ❑ Garage 2' Number of Bedrooms 3
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) Owner must cont ct Health Department 6 months prior to expiration for permit renewal.
. z.._ _ e_
PERMIT CONDITIONS:
I. Performance: System shall perform in accordance with Rule .1961.
II. 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:
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the s disposal system on the above captioned property.
Type of system: El Conventional ews Other 25�' /v {Z" os Septic Tank: �' gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 2 of each ditch )2,0 feet ditches 3 feet ditches 22 inches
French Drain Required: Linear feet
Authorized State Aent�� ✓-- Date ' Z
14- 5- 32849R (9)
14- 5- 32849R (10)
14- 5- 32849R (11)
14- 5- 32849R (12)
14- 5- 32849R (13)
V1
(
99
w�
t
k
14- 5- 32849R (14)
14- 5- 32849R (15)
14- 5- 32849R (1)
14- 5- 32849R (2)
14- 5- 32849R (3)