OPHTE#L 3(s/D� Harnett County Department of Public Health 23619
PERMIT # 2gyoa Operation Permit
[New Installation Septic Tank LJ Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:,3rt /-7o�, 2-C4) t{; ( I C1a UYU-0- %Db
Name: (owner) SUBDIVISION AgAA ,K LOT # 7 -
System
System Installer. Registration #
Basement with plumbing: ❑ Garage ❑ umber of Bedrooms S
Type of Water Supply: ❑ Community Cil Public ❑ Well Distance from well feet
System Type: 25 t e' Ceti. 5 il % 67- Types V and VI Systems expire in S 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
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
/f0 FlBht_
-5r*7r',06
System shall perform in accordance with Rule .1961. -c5x,1-'7o3 jZ&b6a—: t ( C ( yu
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 seewwa�" disposal system on the above captioned property.
Type of system: El Conventional Id Other 25°/a 0,94SU C-f-LvL Septic Tank 04'0 gallons Pump Tank: gallons
Subsurface No. of exact length width ofdepth of
Drainage Field ditches of each ditch 80 feet ditches 3 feet ditches ZY inches
French Drain Required: Linear feet
Authorized State A Date
15-5-36107 (1) 15-5-36107 (2) 15-5-36107 (3) 15-5-36107 (4)
15-5-36107 (6) 15-5-36107 (7) 15-5.36107 (8)
15-5-36107 (5)