OPHTE# 14 -5-- 34*)1 -4 Harnett County Department of Public Health 23791
PERMIT # 280!W Operation Permit
Q" New Installation g' Septic Tank E?r' Nitrification line ❑ Repair ❑ Expansion
PROPERTY LOCATION;Yi y <T1/— P4sae. teX
Name: (owner) 44" 5 L4-,c� SUBDIVISION LOT #
System Installer: Ke.&tN —4-Q_^u.x--e04.,d Registration #
Basement with plumbing: El Garage I�Number of Bedrooms S
Type of Water Supply: ❑ Community 12"Public ❑ Well Distance from well feet
System Type: 25% R.s3-E>VdX7Ar— %r Er, -My ._ZeG FZwlJypes V and VI Systems expire in S years.
(In accordance with Table a) OwnerDHealth Department 6 months prior to expiration for permit renewal.
This system has been installed compliance with appliable North Carolina 41.ul Sa les for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and construction Authorization.
I S ~
I. Performance:
Il. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
r
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 ElPWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional LY Other 25ik Septic Tank: I %b c gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch Jb& feet ditches 3 feet ditches 22,116 inches
French Drain Required: Linear feet / �1
Authorized State AgeL"Z— Date ^ L( —f
14-5-34913 (1)
14-5-34913 (2)
rr
14-5-34913 (3)
14-5-34913 (4)
14-5-34913 (5)
14-5-34913 (6)
14-5-34913 (7)
14-5-34913 (11) 14-5.34913 (12)
14-5-34913 (8)
14-5-34913 (9)
14-5-34913 (10)