OP RRRATE #11 -5-- 3 280 ;U11 Harnett County Department of Public Health 2 3 3 1
PERMIT # 2-2q - 0 eration Permi
New Installation Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:a
Name: (owner) SUBDIVISION LOT # -_
System Installer: % h Registration #
Basement with plumbing: ❑ Garage ber of Bedrooms
Type of Water Supply: ❑ Community EO Public ❑ Well Distance from well feet
System Type: -49-- A Z 1—%OAL-111 3 Types V and VI Systems expire in 5 years.
(In accordance with Table V a) 0 ner must contact Health Department 6 months prior to expiration for permit renewal.
t_t aJ - -
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.
PERMIT CONDITIONS:
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
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.
y
❑ D -Box ❑ Pump ❑ Alarm ❑ H12O1-ine ❑ PWR Line
Following are the specifications for the sewagofisposal system on the gbove captioned property.
Type of system: El Conventional Other & -m��� �� Septic Tank: gallons Pump Tank: gallons
Subsurface No. of exact length r° width of depth of
Drainage Field d. ss of each ditch feet ditches feet ditches inches
French Drain Required: — \\ Linear feet
Authorized State Agent ��� °�'1`"` CS ��S Date >> ID, 1`-S
0
ti
r
t
t
,
55 M
a
"ri't'es"
y
14- 5- 3285ORRR (2)
14- 5- 3285ORRR (3)
14- 5- 3285ORRR (4)
14- 5- 3285ORRR (5)
14- 5- 3285ORRR (6)
l
111 '
14- 5- 3285ORRR (7)
14- 5- 3285ORRR (8)
14- 5- 3285ORRR (9)
14- 5- 3285ORRR (10)
14- 5- 3285ORRR (11)
))V
dYV 1
rt
14- 5- 3285ORRR (12)
14- 5- 3285ORRR (13)
14- 5- 3285ORRR (14)
14- 5- 3285ORRR (15)
14- 5- 3285ORRR (16)
14- 5- 3285ORRR (1)