OPHTE# L.5 -5--3C33o Harnett County Department of Public Health 23819
PERMIT # LSA, II 13 -"
Operation Permit
L3 New Installation 2"Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: ALr43-i
Name: (owner) _'ST&W l3,ac ;!5r.4e_ SUBDIVISION _ 44sisi A-=J� LOT # .5z -
System Installer. zr2t. rze 6,alg& — =.e Registration #
Basement with plumbing: ❑ Garageumber of Bedrooms
Type of Water Supply: ❑ Community public ❑ Well Distance from well feet
System Type: LZs i a Types V and VI Systems expire in S years.
(In accordance with Table V a) Owner must can « 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�ent and Disposal, and all conditions of the Improvement Permit and Construction Authorization
PERMIT CONDITIONS
I. Performance:
ll. Monitoring:
111. Maintenance:
IV. Operation:
V. Other.
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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 ❑ H2OLine ❑ PWR Line
Following are the specifications for the sa disposal system on the above captioned property.
Type of system: El Conventional
Conventional Other 20% ADYcnod) r4 -r1 Septic Tank: I Jo O gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches .j of each ditch too feet ditches feet ditches IZ? s $ inches
French Drain Required: Linear feet
Authorized State A&t__ Z i%/( Av4%,o -. —V Date I t-
15-5-36330 (1)
15-5-36330 (2)
15-5-36330 (3)
15-5-36330 (4)
15-5-36330 (5)
15-5-36330 (6)
15-5-36330 (11)
15-5-36330 (7)
15-5-36330 (8)
15-5-36330 (9)
15-5-36330 (10)