OPHTE# hi-�3a-� �� Harnett County Department of Public Health 23385
PERMIT # Operation Permit
New Installation Septic Tank nNitrification Line ❑ Repair ❑ Expansion
Q PROPERTY LO(ATION:
Name: (owner) ki LL C�2.>C. \AO m<-5 SUBDIVISION Pe, -S% Q o ) LOT # 5ZL,
System Installer. Registration #
Basement with plumbing: ❑ GarageX Number of Bedrooms 3
Type of Water Supply: ❑ Community Public ElWell Distance from well 1 t7 'Z feet
System Type: _1— Types V and VI Systems expire in S 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 (onstmction Authorization
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PERMIT CONDITIONS:
I. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ Na
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
Other:
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional Other QVm4"Sc �rMe+sSC>r+— Septic Tank 1000 gallons Pump Tank 100C' gallons
Subsurfaceexact length width of depth of
Drainage Field ditches of each ditch 1�Z 0 feet ditches 3 feet ditches 2Lat-30 inches
French Drain Required: Line1L feet
Authorized State Agent 'N,-,�.�� W-tv Date