OPHTE# Harnett County Department of Public Health 23486
PERMIT # Z_78L0 Operation PPerpt
2 New Installation 2 Septic Tank lX Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: _-YQYZ 7 ��r�d E►ta -vim _.f-D
Name: (owner) SUBDIVISION LOT #
System Installer: ;F SJ-XJ Registration #
Basement with plumbing: ❑ Garage ❑ umber of Bedrooms
Type of Water Supply: ❑ Community LEI Public ❑ Well Distance from well feet
System Type: G)*LLoi, Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must cunt ct Health Department 6 months prior to expiration for permit renewal.
This system has been installed in
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with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
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PERMIT CONDITIONS:
1. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
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System shall perform in accordance �ith Rule .1$1.
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 ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewa disposal system on the above captioned property.
Type of system: ❑ Conventional 1Z Other Pyrn� kP ?f% U"� Septic Tank: f 0 v d gallons Pump Tank: l� ° a gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch SC) feet ditches 3 feet ditches Z inches
French Drain Required: Linear feet
Authorized State Agents Date
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14 -5 -33069 (4)
14 -5 -33069 (5)
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14 k
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14 -5 -33069 (17)
14 -5 -33069 (18)
14 -5 -33069 (1)