OP'lTE#_1q-.:5;_-,399 T Harnett (ounty Department of Public Health
J
PERMIT # 2 w Operation Perm—it
13�New Installation L( Septic Tank [:4 Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: �L> f V L
Name: (owner) SUBDIVISION LOT #
System Installer: Registration #
Basement with plumbing: ❑ Garage Vumber of Bedrooms -5
Type of Water Supply: El Community lJ Public ❑ Well Distance from well feet
System Type: Z - pes V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must contac ealth 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
I
XX 119 /.
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PERMIT CONDITIONS:
1. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
ystem s a !i iii m actor ante 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 ❑
Following are the specifications for the sewap disposal system on the above captioned property.
Type of system: ❑ Conventional Z Other t5%Septic Tank: l `�
Subsurface No. of exact length width of
Drainage Field ditches 3 of each ditch Z feet ditches 3
French Drain Required: Linear feet
Authorized State Age e-5- T Date
H2OLine ❑
PWR Line
gallons Pump Tank: gallons
depth of
feet ditches 2— inches
-1- to _15—
14-5-34944 (1)
14-5-34944 (2)
14-5-34944 (3)
14-5-34944 (4)
14-5-34944 (5)
14-5-34944 (6)
14-5-34944 (7)
14-5-34944 (8)
14-5-34944 (11) 14-5-34944 (12) 14-5-34944 (13)
14-5-34944 (9)
14-5-34944 (10)