OP RHTE# f3-3-Ja-XXI-2 Harnett County Department of Public Health 23689
PERMIT # � 7c- 3,2, Operation Permit �r
Ld New Installation L✓1 Septic Tank L�f Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: 6 r .ed.
Name: (owner) SUBDIVISIONr ✓ i �Ee,-r �:dg e LOT #
System Installer: 7_'XQ'14 �1 '0'P1U'6,9 Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms 41
Type of Water Supply: ❑ Community IZIPublic ❑ Well Distance from well 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.
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
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PERMIT CONDITIONS:
I. Performance:
11. 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 ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewa6- disposVj system on the above captioned property.
Type of system: ❑ Conventional le Other u.� X04. CZle5,0V_ Septic Tank: 660 gallons Pump Tank: Q60 gallons
Subsurface No. of exact length width of depth of
Drainage Field ditchesof each ditch CSU feet ditches —3 feet ditches / inches
French Drain Reauired:A ' Linear feet
Authorized State Agent , ; n� _11K) Date
13-J 2z�2