OPHTE#[SS-3sy9Z Harnett County Department of Public Health 2 3 g 1 4
PERMIT# 2W23z Operation Permit
["New Installation 0�Septic Tank ZINitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION
Name: (owneroa n/��lla.�w �es SUBDIVISION �a�) LOT #
System Installer. Registration #
Basement with plumbing: ❑ Garage 01umber of Bedrooms 3
Type of Water Supply: ❑ Community 2' Public ❑ Well Distance from well feet
System Type: e§% u 1+e-gi'4AV` pe 40' e. —A{jgpes V and VI Systems expire in S years.
(In accordance with Table V a) the prior to expiration for permit renewal.
This system has been installed i mpli so with applicable North Carolina General statutes, Rules for Sewage Treament and Disposal, and all
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
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Co CX005 cAea-'
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.
of the lou roeement Permit and Consbustion
❑ D -Box ❑ Pump ❑ Alarm ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sew disposal system on the above captioned property.
Type of system: El Conventional Other Septic Tank J000 gallons Pump Tank gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch 30D feet ditches 3 feet ditches 63 inches
French Drain Required: Linear feet
Authorized State gent C Date 11-13 — t
i At
15-5-35482
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15-5-35482 (1) 15-5-35482 (2) 15-5-35482 (3) 15-5-35482 (4) 15-5-35482 (5)
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15-5-35482 (6) 15-5-35482(7) 15-6-35482(8) 15-5-35482(9) 15-5-35482 (10)
15-5-35482(11) 15-5-35482(12) 15-5-35482 (13) 15-5-35482(14) 15-5-35482 (15)
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15-5-35482(16) 15-5-35482 (17) 15-5-35482(18)
6
ABC
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15-5-35482(l) 15-5-35482 (2) 15-5-35482 (3) 15-5-35482(4) 15-5-35482 (5)
,All. vr:
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15-5-35482 (6) 15-5-35482 (7) 15-5-35482 (8) 15-5-35482 (9) 15-5-35482 (10)
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155--55-(35482(11) 15-5-35482(12) 15-5-35482(13) 15-5-35482(14) 15-5-35482(15)
15-5-35482 (16) 15-5-35482 (17) 15-5-35482 (18)