OP RHTE# IV 5�3V? 0-?IZ Harnett County Department of Public Health 23495
PERMIT # L e 71 Z / Operation Per it — /
2 New Installation LJ Septic Tank L2' Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATIONza. YX7 ,t3,j�� !-L
Name: (owner)524tae 1314, A/ -SUBDIVISION / _ Pr LOT # 2
System Installer: Registration #
Basement with plumbing: ❑ Garage Z NN ber of Bedrooms
Type of Water Supply: El Community L�" P blic El Well Distance from well et
System Type: s T -=-6 es V and VI ystems expire in 5 years.
(In accordance with Table V a) Owner must contact ealth Departme it 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable Nortq Carolina General Statutes, Rules for Sewage Treatment and
PERMIT CONDITIONS:
I. Performance:
Il. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
T>
r IC;* titi
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.
all conditions of the Improvement Permit and Construction Authorization.
❑ D -Box ❑ Pump ❑ Alarm ❑ 1-1201-ine ❑ PWR Line
Following are the specifications for the sewdisposal system on the above captioned property.
Type of system: ❑ Conventional 1!r Other Z514 Septic Tank: /60 Q gallons Pump Tank: gallons
Subsurface No. of exact length widthof depth of
Drainage Field ditches -; of each ditch 8C) feet ditches 3 feet ditches inches
French Drain Required: Linear feet
Authorized State A ent��e,—X � Date ZO
14-5-34783R (1)
14-5-34783R (2)
14-5-34783R (3)
14-5-34783R (4)
14-5-34783R (5)
14-5-34783R (8)
14-5-34783R (9)
14-5-34783R (11)
14-5-34783R (12)
14-5-34783R (13)
14-5-34783R (14)
14-5-34783R (10)