OPHTE# 1'5-- : -35-5-711 Harnett County Department of Public Health 23596
PERMIT # Zp2Zs` 0 e� ration Per It ��
L✓( New Installation Septic Tank E� Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATIONIE,-�yy5®i��- 61" /60
Name: (owner) C� �".� SUBDIVISION LOT # !b'
System Inst41le1 r — Registration #
Basement wit: ❑ Garage f� mer of Bedrooms
Type of Wate❑ Community Public ❑ Well Distance from well feet
System Type:�''® 2 "7" '1a T pes V and VI Systems expire in 5 years.
(In accordancle V a) tj Owner t contact Health Department-6-fl*mhs—prior—ta',({{{expiration for permit renewal.
I
I..,,nnt Pormit and r—tnirtinn Anthnriratinn.
This system has been instauea in compuance wim appucaoie Hums Lamumra ucec
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PERMIT CUNUIIIUN):
I. Performance:
II. 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 ❑ 1-12O1-ine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional CX Other b t74-rart)4974"Z-- Septic Tank: /&00 gallons Pump Tank: o v v gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 3 of each ditch feet ditches -3 feet ditches ZB -) f9) inches
French Drain Required: Linear feet
Authorized State ABA-y� -- C �� Date
15-5-35374 (1)
15-5-35374 (2)
15-5-35374 (3)
15-5-35374 (4)
15-5-35374 (5)
15-5-35374 (6)
15-5-35374 (11)
15-5-35374 (7)
15-5-35374 (8)
15-5-35374 (9)
15-5-35374 (10)