OPHTE# �`� Harnett County Department of Public Health 23306
PERMIT # ����� OlDeration Permit
1 New Installation A Se tic Tank X Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:
Name: (owner) )4dmQ* 1 ssc SUBDIVISION Cf *<WLl A-2 LOT #
System Installer:' Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 1 ®d feet
System Type: _ L 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.
ma system nas neen mstaoea in compliance wan appucame norm carouna uenerat statutes, HIM Tor Sewage treatment ano uaposai, ano au conanons os me improvement rerma ano construcnon eumonzanon.
PERMIT CONDITIONS:
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
• s♦
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.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal system on the abovtcaptio property.
Type of system: El Conventional Other.�'� .'ate Septic Tank: gallons Pump Tank: gallons
Subsurface No. o xact length width of depth of
Drainage Field ditches ��t f each ditch )iD,0 feet ditches feet ditches ,�_ inches
French Drain Reauired:..�
ll-)-S" 3aq.�s