OPHTE# /s -s-363-9/ Harnett County Department of Public Health
23921
PERMIT # ?, Operation Permit
(�ew Installation Ell-eptic Tank nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATIONr:
Name: (owner) �S T SUBDIVISION ✓yaa«�.a }er LOT # 8
System Installer. GarKV fo�-:c Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms
Type of Water Supply: ❑ Community R'Public ❑ Well Distance from well feet
System Type: ZM—a 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 Statutex Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
PERMIT CONDITIONS
I. Performance: System shall perform in accordance with Rule .1961.
ll. Monitoring. As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ No
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
❑
I 'at
Pump ❑
Alarm ❑ H2OLine ❑ PWR Line
Following are the
specifications for the sewsQS,disposal
F
Type of system:
❑ Conventional B' Other
r
Septic Tank: o0 6 gallons Pump Tank: gallons
Subsurface
No. of
P
width of depth of
Drainage Field
ditches
of each ditch JOC) feet
ditches Jr feet ditches yd inches
s
spyy
I ra,
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PERMIT CONDITIONS
I. Performance: System shall perform in accordance with Rule .1961.
ll. Monitoring. As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ No
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
❑
D•Box ❑
Pump ❑
Alarm ❑ H2OLine ❑ PWR Line
Following are the
specifications for the sewsQS,disposal
system on the abov captioned property.
��.
Type of system:
❑ Conventional B' Other
��: W 5+^
Septic Tank: o0 6 gallons Pump Tank: gallons
Subsurface
No. of
exact length
width of depth of
Drainage Field
ditches
of each ditch JOC) feet
ditches Jr feet ditches yd inches
French Drain Required: Linear feet
c
Authorized State Ag r Date // � 7 /9 a /S
1,5=s = -7 5-g 1