OP RHTE# / 7 ,5--5J97 2 Harnett County Department of Public Health 23242
PERMIT # n2% 97a Operation Per it
New Installation Er Septic Tank EK Nitrification Line ❑ Repair ❑ Expansion
f PROPERTY LOCATION:
Name: (owner) V `rC c e : /� SUBDIVISION LOT #
System Installer: Ge,r-JA - e,-ple Registration #
Basement with plumbing: ❑ Garage ❑ umber of Bedrooms .7
Type of Water Supply: El Community L✓t Public ❑ Well Distance from well feet
System Type: 17T 4 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
rLm•ni WNUMVivs:
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
/7-::p
" ,
f
b7.
�s
yam.
fD
s /[
� °ICI
C,
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 ❑
Following are the specifications for the sew a disposal system gn the above captioned property.
Type of system: El nti
Conveonal Other ZF /",k)
Subsurface No. of exact length
Drainage Field ditches of each ditch `�J� feet
Alarm ❑ H2O1-ine ❑ PWR Line
Septic Tank: 1600 gallons Pump Tank: gallons
width of depth of
ditches feet ditches %8 inches
French Drain Required: Linear feet f
Authorized State Agen ��*- �-� Date 7 /18
�y -,5`� ?fir ?6.2