OPHTE# /Z -5-- 2 94, Y Harnett County Department of Public Health
PERMIT # Z-70 39 Operation Permit
M NeW Installation Y Septic Tank L/J Nitrification Line
PROPERTY LOCATION:azivz6 rc.J
Name: (owner) roc SUBDIVISION
System Installer: (,a,1— Cam- - Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms_
Type of Water Supply: ❑ Community Z Public ❑ Well Distance from well feet
System Type: Z:M Ff2 Z_, Wr G Qt)?, Types V and VI Systems expire in 5 years.
Repair ❑ Expansion
# S^ "C'.
(In accordance with Table V a) I Owner mus contact Health Department 6 months prior to expir ion for permit renewal.
This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage tment a /Dijosal, and all conditions of the Impr ement Permit and Construction Authorization.
PERMIT CONDITIONS:
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
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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.
V. Other:
❑
D -Box ❑
Pump ❑ Alarm ❑
H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal
system on the above captioned property.
Type of system:
❑ Conventional E2' Other
Zs % 'fW—b a - a Septic Tank:
1 a o gallons Pump Tank: gallons
Subsurface
No. of
exact length width of
depth of
Drainage Field
ditches 3
of each ditch f ° ° feet ditches
3 feet ditches z 4 inches
French Drain Required: Linear feet
Authorized State A nt - � Date