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OPHTE # /` /— V S -3M ) Harnett County Department of Public Health 23336 !� PERMIT # 3z�?s Aeration Permit New Installation Septic Tank ER Nitrification Line ❑ Repair ❑ Expansion PROPERTY LOCATION :3/yp7 Name: (owner) ';-r SUBDIVISION LOT # G� System Installer: Registration # Basement with plumbing: ❑ Garage mber of Bedrooms 3 Type of Water Supply: ❑ Community Z Public ❑ Well Distance from well feet System Type: ZMfy --t Q_A1 ,5 T,&-Zr— 0 1,-7_yk7 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 renewq. 9N installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction PERMIT I. II. III. Performance: ystem shall perform in accordance with Rule .1961,_ Monitoring: s r— equtrecrby IF6 .1961. Maintenance: As required by Rule .1961. Other: Subsurface system operator required? Yes ❑ No ❑ If yes, see attached sheet for additional operation conditions, maintenance and reporting. IV. Operation: V. Other: ❑ D -Box ❑ Pump ❑ Alarm ❑ Following are the specifications for the sewage disposal system on the above captioned property. Type of system: ❑ Conventional © Other 25- 76y7,00ycLr= a-- Septic Tank: �66c'> Subsurface No. of exact length �` width of Drainage Field ditches L4 of each ditch 8D feet ditches French Drain Required: Linear feet 1✓ \ H2OLine ❑ `j L' PWR Line gallons Pump Tank: gallons depth of feet ditches 2!1 inches Authorized State Aged -- l —. C /% ' Date 47- - f L _- b