OPHTE# 14 — 5r33b11 Harnett County Department of Public Health 23402
PERMIT # Operation Permit
New Installation Septic Tank "'K Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:
Name: (owner) Me 5s )iA o MF— e V t c-.o C-(-5 SUBDIVISION LOT #
System Installer: e ti o• flb G Registration #
Basement with plumbing: ❑ GarageX Number of Bedrooms `yi $ °- 03 ooM
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 1 O 0 feet
System Type: 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
w* a cu� v N Q:p
9
Q
t
V
E
t3* sN6
110 WS E. q
a� 1
r cAR.�,6E
t 2.Ef'fl � tZ to
t
a. ®p'
rttSPlll LUNUIIIUNN:
1. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring: As required by Rule .1961.
111. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No
If yes, see attached sheet for additional operation ct
IV. Operation:
V. Other:
maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑
Following are the specifications for the sewage disposals stem on the above captioned property.
Type of system: ❑ Conventional Yk Others— F" 0w Septic Tank:
Subsurface No. of exact length width of
Drainage Field ditches of each ditch 40 feet ditches _
French Drain Required: Gear feet
1`12O1-ine ❑
PWR Line
1 ®o d gallons Pump Tank: gallons
depth of
3 feet ditches a2+° inches
Authorized State Agent ��� ��������� Qf>)5 Date al t