OPHTE# I°c -� -53 0 Harnett County Department of Public Health 23348
PERMIT # 2T 8-1 J. /Operation Permit
d New Installation E� Septic Tank E Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:
Name: (owner) G7 y 1r&6gLw-- 4r-, SUBDIVISION it LOT # Z `t
System Installer: Vie; Registration #
Basement with plumbing: ❑ Garage "mber of Bedrooms
Type of Water Supply: ❑ Community Ld' Public ❑ Well Distance from well feet
System Type: Z Xr.) 24-0t- ct7z__� ;E7,rAz— Types V and VI Systems expire in 5 years.
(In accordance with Table V a) cb, �Oyvier 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 l isposal, and all conditions of the Improvement Permit and Construction Authorization
PERMIT CONDITIONS:
I. Performance:
II. Monitoring:
111. Maintenance:
IV. Operation:
V. Other.
kC
V I,
I?
b✓ — - V
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 ❑
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional E?" Other L5`4:' ,r?,ftv —L,, Septic Tank: 1-4,0
Subsurface No. of exact length width of
Drainage Field ditches 3 of each ditch P ° 0 feet ditches 3
H2OLine ❑
PWR Line
gallons Pump Tank: gallons
depth of
feet ditches Z O inches
French Drain Required: Linear feet
Authorized State Agent L Date z'o —Zf
14 -5 -33626 (2)
14 -5 -33626 (3)
14 -5 -33626 (4)
14 -5 -33626 (5)
14 -5 -33626 (6)
14 -5 -33626 (7)
14 -5 -33626 (1)
14 -5 -33626 (8)
14 -5 -33626 (9)
14 -5 -33626 (10)
14 -5 -33626 (11)