OPHTE #- 15®5 -is -7"00 Harnett County Department of Public Health 23658
PERMIT # 3) Operation Permit
New Installation '5� Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: a
Name: (owner) m �� � . —C SUBDIVISION LOT #
11
System Installer: Eao-,G C W2-tnjCSL Registration #
Basement with plumbing: ❑ Garage.X Number of Bedrooms L-)
Type of Water Supply: ❑ Community '19 Public ❑ Well Distance from well O feet
System Type: 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.
uu� 3y3e11 ua, ueen inscaueo in compuance with
PERMIT rmmnITIAKIC•
I. Performance:
II. Monitoring:
111. Maintenance:
IV. Operation:
V. Other.
North Carolina General Statutes, Rules for Sewa¢e Treatment and
4ZO
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 cc
M
H 0 bsF—
i
and all conditions of the Improvement Permit and Construction Authorization.
maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑
Following are the specifications for the sewage disposal system on the above captioned erty.
Type of system: El Conventional ,� Other �yi 1� :a�l1 1A Septic Tank:
Subsurface No. of exact length width of
Drainage Field iii- �S -- of each ditch 3 ( 0 feet ditches
French Drain Required: Linear feet
H2OLine ❑
PWR Line
gallons Pump Tank: gallons
depth of
feet ditches )10 inches
Authorized State Agent , ����� 9-'-',A!5 Date (Z he
15 - 5-- 3 ! �g