OP Ra •Harnett CountyDepartment , Public
i
PERMIT # Operation Permit
New Installation X Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:
Name: (owner) SUBDIVISION JOT #
System Installer: ► 0 b Q -Q cv Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 1O feet
System Type: e ' ^ 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
PERMIT CONDITIONS:
I. Performance:
II. 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 ❑ N
If yes, see attached sheet for additional operation cc
maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑
Following are the specifications for the sewage dispos stem on the abov captio property.
Type of system: El Conventional Other '�AAg� ��r Septic Tank: 1('_700 gallons Pump Tank:
Subsurface No. of exact length width of depth of
Drainage Field disc a of each ditch t S"C1 feet ditches 3 feet ditches
French Drain Reauired\ 'linear feet
Authorized State Agent_ 4� ____J`—ZV\\ 9415 Date
PWR Line
gallons
inches
U- 5- 301612