OP RHTE#_I14-5—&-_1 979, Harnett County Department
PERMIT # ) Operation Permit
:P� New Installatiori_'�K Septic Tank X Nitrification line ❑ Repair ❑ Expansion
PROPERTY LOCATION: CL_P+cL- e_ 4S>
Name: (owner)-- ES'.�1. �' `��'' SUBDIVISION LOT #
System Installer: `L-..?,,4K:.I aaRG Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms I
Type of Water Supply: ❑ Community 1 K 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 contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Carolina General statutes, Mules for sewage Treatment ana msposal, ano an commons or me improvement rermn ana Unsuruaion Humonzanon.
l
PERMIT CONDITIONS:
I. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring: As required by Rule .1961.
111. 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 ❑ Alarm ❑
Following are the specifications for the sewage disposal �s.Xstem on the above captioned property.
Type of system: El Conventional Other 1> -- a •( Septic Tank: a
Subsurface f exact length width of
Drainage Field ditches of each ditch ® feet ditches
French Drain Required: `� irk feet
Authorized State Agent �! t n- °> Date
H2OLine ❑
PWR Line
gallons Pump Tank: gallons
depth of
feet ditches 1F? inches
0 ip,