OPHTE# J3 0 Harnett County Department of Public Health 23274
PERMIT # Operation Permit
New Installation )< Septic Tank X Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:
Name: (owner) tcz-»LL— ucLr-E -55 SUBDIVISION LOT #
System Installer: ,— �> , Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms
Type of Water Supply: ❑ Community ❑ Public ,< Well Distance from well feet
System Type: = C, 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.
This 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
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:
❑ D -Box ❑ Pump ❑
Following are the specifications for the sewage disposal system on the above captioned property.
Type o ❑ Conventional Other 2 `� 1�a P✓
Subsurface exact length
Drainage Field ditches r of each ditch feet
French Drain Required: ear feet
Alarm ❑
H2O1-ine ❑
PWR Line
Septic Tank: Ji 000 gallons Pump Tank: gallons
width of depth of
ditches feet ditches inches