OP RRRHTE #13'<- 3ai Aek Harnett founty Department of Public Health 23798
PERMIT # ZS7s Operation Per It
Lf New Installation Septic Tank L3' Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: %h✓y 4Z
Name: (owner) ��P SUBDIVISION T— LOT # 61-26X
System Installer: ! Registration #
Basement with plumbing: ❑ I Garage ��' caber of Bedrooms
Type of Water Supply: ❑ Community L Public ❑ Well Distance from well Net
System Type Sal, 7 — types V and VI Systems expire in 5 years.
(In accordan with Table V a) Owner must contMi
t Health Department 6 months prior to expiration for permit renewal.
This system has blim installed in Compliance with applicable North Carolina General Statutes. Rules for Sewate Treatment and Disposal, and all mndi%ons of the Improvement Permit and Construction Authorization.
PERMIT CONDITIONS:
I. Performance:
If. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
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 ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sewa a disposal s%�tem on the above captioned property.
Type of system: ❑ Conventional IfOther 1.5 �o It St Septic Tank: �OdO gallons Pump Tank: gallons
Subsurface No. of exact length _-% width of depth of
Drainage Field ditches of each ditch 100 feet ditches 3 feet ditches Ztf inches
French Drain Required: Linear feet
Authorized State Age t Date /b — i t —i s —
(/
13-5-3092ORR (1)
13-5-3092ORR (6)
13-5-3092ORR (2)
l r i4
13-5-3092ORR (7)
13-5-3092ORR (3)
13-5-3092ORR (4)
13-5-3092ORR (5)
13-5-3092ORR (6)
13-5-3092ORR (9)
13-5-3092ORR (11) 13-5-3092ORR (12) 13-5-3092ORR (13)
13-5-3092ORR (14)
13-5-3092ORR (10)