OP REPAIR - Cooper Farms Lt 11— -C-. Harnett County Department of Public Health
1
PERMIT # Operation Permit
❑ New Installation ❑ Septic Tank �< Nitrification Line XRepair ❑ Expansion
PROPERTY LOCATION:
Name: (owner) fin. a crC.S SUBDIVISION Coop fig-,. F;�r.s LOT # — � l—
System Installer: Gp,2,N Go, Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms
Type of Water Supply: ❑C munity Public El Well Distance from well feet
System Type: I_'t' 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 t.arohna General statutes, Rules for )ewage treatment and Disposal, and all conditions of the Improvement rermtt and lonstrucnon AUtnorization.
G Lt
PERMIT CONDITIONS:
I. Performance: System shall perform in accordance with Rule .1961.
II. Monitoring: As required by Rule .1961.
111. Maintenance: As required by Rule .1961. Other: ,�r'
Subsurface system operator required? Yes ❑ No i�6
If es, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation: W V'S' tq �c2R+��vt ,NG 1oiQ.y
V. Other: `To
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: El Conventional Other-*^Act%9-02— Septic Tank:' )5,0NC, gallons Pump Tank: EV)5TtNC gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch 1 0 0 feet ditches 3 feet ditches 1'( -;.� inches
French Drain Required: s Linear feet
Authorized State Agent �WW Date -7/3