OPHTE# IS S—�- /98Harnett County Department of Public Health 23788
PERMIT #0 erat'io_n Permit
[ N/ ew Installation d Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION^:bUIltSrL.�.�SGl4-tJ
Name: (owner) SUBDIVISION 1A.'_0 LOT # <_
System Installer: Registration #
Basement with plumbing: ❑ Garageumber of Bedrooms 3
Type of Water Supply: ❑ Community LSI Public ❑ Well Distance fr well e
System Type: �fl--`�` es V and VI Systems pire in 5 years.
(In accordance with Table V a) ner must contact Department 6 in nths prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Carolina Ge al Statutes, Rules for a e Treatment and Disposal, and al conditions of the Improvement Permit and Construction Authorization.
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PERMIT CONDITIONS:
1. Performance: System shall perform in accordance with Rule .1961.
II. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
❑ D -Box ❑ Pump ❑ Alarm ❑
Following are the specifications for the sewa;e disposals stem o the above c tioned property.
Type of system: ❑ Conventional Other i�%o U Septic Tank:
Subsurface No. of exact length %v width of
Drainage Field ditches of each ditch feet ditches 3
PWR Line
gallons Pump Tank: gallons
depth of
feet ditches inches
French Drain Required: Linear feet
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