OP RHTE# 13 S 3z3Harnett County Department of Public Health 23811
PERMIT # 7A395- 0 eratlon Per It
L2r New I e a tit c Tank 0 Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: ZSt f I�, 2b
Name: (owner)<% a SUBDIVISION LOT # Z
System Installer. Cix.a Registration #
Basement with plumbing: ❑ Garageber of Bedrooms
Type of Water Supply: El Community �ic ❑ Well Distance from well feet
Sys em Type: 5 S Types V and VI Systems expire in S years.
(In ccordance with Table V a) Owner must co « Health Department 6 months prior to expiration for permit renewal.
This Istern has been installed in compliance with applicable Month Carolina General Statutes, Rules for Sewage Treatment and Disposal, and allco;odz Im oeement Permit and Commuz/on Authorization.
To
Q—p �F V
PERMIT CONDITIONS:
I. Performance:Vsrequired
hall perform in accordance with Rule .1961. LJ
It. Monitoring:red by Rule .1961.
III. Maintenance: by Rule .1961. Other:
ce system operator required? Yes ❑ No ❑ee attached sheet for additional operation could 'prs maintenance and reporting.
IV. Operation: j
V. Other.
❑ Oka ❑ Pump 072IC-&61 IZ 1" 16 s
14261-ine ❑ PWR Line
Following are the specifications for the sews disposal stem on the above captioned property.
Type of system: ❑ Conventional f(0therL��ONCfl-cs— Septic Tank: / 2 Q 2 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 3 of each ditch 13 3 feet ditches 3 feet ditches 1Z y 1 inches
French Drain Required: Linear feet
Authorized State A t Date 1 0— I
13-5-3239OR (1)
13-5-3239OR (2)
13-5-3239OR (3)
13-5-3239OR (4)
13-5-3239OR (5)
13-5-3239OR (6)
13-5-3239OR (7)
13-5-3239OR (8)
13-5-3239OR (11) 13-5-3239OR (12) 13-5-3239OR (13)
13-5-3239OR (9)
13.5-3239OR (10)