OPHTE# ,'7-s 16!j.C7 Harnett County Department of Public Health 23507
PERMIT # ?x!-72. 'Operation Pe it
[/'New Installation Septic Tank D//Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATIO G
Name: (owner) --3#C L4:,._ 2,-c SUBDIVISION ALvx��s ? LOT # 7
System Installer: z iP r Registration #
Basement with plumbing: ❑ Garageumber of Bedrooms 3
Type of Water Supply: ❑ Community LJ Public ❑ Well Distance from well feet
System Type: �' EZ.. 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
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PERMIT CONDITIONS:
1. Performance:
II. Monitoring:
111. 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.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the seewwa disposal system on the above captioned property.
Type of system: El Conventional I� Other OA Septic Tank: /000 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of on
Drainage Field ditches Z. of each ditch 190 feet ditches feet ditches ") L3 inches
French Drain Reouired: Linear feet
Authorized State AR nt ,�^�-- ---- �__ 1y( Date 3-01-15-