OP RATEOLA i Harnett
r County Department , Public Health 23666
PERMIT # 1 Operation Permit
New Installation Septic Tank`, Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: P>jip. 29
Name: (owner) C j i311,4r. SUBDIVISION 'vl Q ez si LOT # 15
System Installer: \ ��� (Lc:.rzQ Registration #
Basement with plumbing: ❑ Garage >11umber of Bedrooms
Type of Water Supply: ❑ Community 1,'X\ Public ❑ Well Distance from well feet
System Type: a 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 Ireatment and
aria an conditions m me improvement rermt ana construcuon Humonzaoon.
C. W C—.ND 01..y -'j ��
PERMIT CONDITIONS:
I. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring: As required by Rule .1961.
111. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ N
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal s stem on the above ca Honed erty.
Type of system: El Conventional `K Other 1-S D tv+� &Q � � Septic Tank: kb Q 0 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field difces of each ditch
30 feet ditches feet ditches 7 inches
French Drain Required: ear feet
Authorized State Agent 5~ S Date 'S