OPHTE# 1q -5 -33 -7(- Harnett County Department of Public Health
2335
PERMIT # Z"1 8(�13 _eration Per 't
�J" N�ew P
c Tank YNritifcation Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: M--tss3
Name: (owner) /LLB SUBDIVISION LOT #
System Installer: /Z/ Il-6 eQ Registration #
Basement with plumbing: ❑ Garage El,,Number of Bedrooms
Type of Water Supply: ❑ Community Z Public ❑ Well Distance from well feet
System Type: 7-'5° , -f— 6 - Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must c ntact 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
PERMIT CONDITIONS
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
and all conditions of the
,r
.,5; 6
W.
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.
_'7 u
Permit and Construction Authorization.
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
a Other ZSLo 2�';��L r—*�-L _ Septic Tank: 1-06
gallons Pump Tank: gallons
Subsurface
No. of
exact IIngth width of
depth of
Drainage Field
ditches
of each ditch 17 feet ditches 3
feet ditches zy ��a inches
French Drain Required: Linear feet
Authorized State Age r- ''� j'�� Date D 2
14 -5 -33762 (2)
14 -5 -33762 (3)
14 -5 -33762 (4)
14 -5 -33762 (5)
14 -5 -33762 (6)
14 -5 -33762 (7)
14 -5 -33762 (8)
14 -5 -33762 (12) 14 -5 -33762 (1)
14 -5 -33762 (9)
14 -5 -33762 (10)
14 -5 -33762 (11)