OP RHTE# -s=3 yr/Z Harnett County Department of Public Health 23588
PERMIT # Operation Per /
IJ' New Installation c Tank 0 Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION -60
Name: (owner) ��� t� ?�- SUBDIVISION�� �7 LOT # _
System Installer: Registration #
Basement with plumbing: ❑ Garage � b of Bedrooms
Type of Water„,�pply: El Community LTJ' Public ❑ Well Distance frorR well feet
System Type: Types V and VI Systems expire in 5 years.
(In accordance with Ale V a) Department 6 months prior to expiration for permit renewal.
Inti system has been mstaneci In compliance with applicable North larolma beneral Statutes, Nules for Sewage Ireatment and Disposal, and all conditions of the Improvement Permit and construction Authorization.
FtKMI] LUNUIITUNS:
1. Performance:
11. Monitoring:
III. 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 sewage disposal
system on the above captioned property.
Type of system: ElConventional
2 Other
Z, 1)W_ U --J
Septic Tank: 0 ,j gallons Pump Tank: 0 0 c) gallons
Subsurface
Drainage Field
No. of
ditches
exact length
of each ditch y feet
width of depth of
ditches feet ditches _ inches
French Drain Required:
_
Linear feet
Authorized State hent ��� ____ !,�/1.� , Date 6 - // --/ �