OPHTE# Harnett County Department of Public Health23505
PERMIT # Z Operation Perm
f 2' New Installation 131Septic Tank E? Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION 2,,tSVis—iZ.4.- /s c Aa L le-�D
Name: (owner) c SUBDIVISION 42! . LOT # yD
System Installer: Registration #
Basement with plumbing: ❑ Garage ember ofFBedrooms - -5
Type of Water Supply: ElCommunity LKublic ElWell Distance from well feet
System Type: es V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner mug4nttachealth 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
PERMIT CONDITIONS:
I. Performance:
II. Monitoring:
111. Maintenance:
IV. Operation:
V. Other:
/— 1744 1 -1"VA
5� 3t.
11 ��
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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.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewa disposal system on the above captioned property.
Type of system: El Conventional Other ZZ '^ i�r�'1, s s-6--- Septic Tank: 100 e) gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch 90 feet ditches_ feet ditches 7- '11 inches
French Drain Reauired: Linear feet
Authorized State Ag - e A�"' Date 3 "Ll `I'�'
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14-5-34943 (1) 14-5-34943 (2) 14-5-34943 (3) 14-5-34943 (4) 14-5-34943 (5)
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14-5-34943 (21)
14-5-34943 (22)
14-5-34943 (23) 14-5-34943 (24)
14-5-34943
(25)