OPHTE#O Harnett County Department of Public Health 23511
PERMIT # Z 37 3 o Operation Plerrmt
Q New Installation LTJ Septic Tank 2"'Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:/5—&s—
Name: (owner) s—dr 14AL'o _...vc. SUBDIVISION l;'���s �d�� LOT # 3L--
System Installer:i vr�/ _ s Registration #
Basement with plumbing: ❑ Garage ��mber of Bedrooms -3
Type of Water Supply:
El Public El Well Distance from well feet
System Type: 15Ko r U 7— Z Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must contac 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
PLKMII LONUIIIUNS:
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
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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 ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sewwaa disposal system on the above captioned property.
Type of system: ❑ Conventional L� Other 2'5y/6 I _ u LT7$1,— Septic Tank: I Uy 0 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch I D d feet ditches 3 feet ditches Z y d inches
French Drain Required: _ Linear feet
Authorized State Amit/, —� —�� 1�y��✓"�YJ-/I/ t;'� Date