OPHTE#SO-s -i•~s Harnett County Department of Public Health 21 4 7 8
PERMIT #-SY10~ Operation Permit
New Installation )Q Septic Tank ❑ RepairX Nitrification Line ❑ Expansion
PROPERTY LOCATION: Aoc oc~- ~-o
Name: (owner) v I r1! C-+-3 "s-, (w cx t b N SUBDIVISION 910 N V-~ VP,Itm LOT #
System Installer: ~Pw, o-) '6 c, R F---3 Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms 3
Type of Water Supply: ❑ Community Public ❑ Well Distance from well \ 00 feet
System Type: 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 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.
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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 ❑ Nox
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other. P u ~R ,aLSv-'1'~ Z V'G s L, ~ F s 1 o G C-N e c -x I
Following are the specifications for the sewage disposAsystem on the abovg captioned property.
Type of system: ❑ Conventional -Nl~ Other "-W o 'c), CMN-,C~
Subsurface No. of exact length
Drainage Field ditches of each ditch S feet
french Drain Required: Linear feet
Authorized State
Septic Tank: 1flO® gallons Pump Tank: Nba() gallons
width of depth of
ditches 3 feet ditches 7 ~ inches
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