OP RRRTE#6-1-r- /L58 Z Harnett County Department of Public Health 23818
PERMIT # /9Z3X' Operation Permit
ZNew Installation Septic Tank 2 Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: st-22t 5—
Name:
Name: (owner) 744ea 4 L igok-ao SUBDIVISION ?e.&% /ham, � LOT # 0
System Installer: C&4 AcQiti -S Registration #
Basement with plumbing: ❑ Garage L'Number of Bedrooms -S
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: pes V and YI Systems expire in S years.
(In accordance with Table V a) Owner must contact flealth Department 6 months prior to expiration for permit renewal.
This system has been iosalled in compliana with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authonation.
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PERMIT CONDITIONS:
I. Performance:
II. 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 ❑ 1120Line ❑ PWR Line
Following are the specifications for the sew disposal
All
4 R 6fT2 t}
Type of system: El
I� G 1
I ft
2rA»txitt —
D' ruga a C A404-
Subsurface
No, of
PERMIT CONDITIONS:
I. Performance:
II. 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 ❑ 1120Line ❑ PWR Line
Following are the specifications for the sew disposal
system on the above captioned property.
Type of system: El
Con IJ Other 2S0,4
2rA»txitt —
Septic Tank / D o d gallons Pump Tank. o o U gallons
Subsurface
No, of
exact length
width of depth of
Drainage Field
ditches _�
of each ditch -7 0 feet
ditches 3 feet ditches z9 ) / n inches
French Drain Required:
linear feet
Authorized State AIR l Date ® - I ) - 3 —
07-5-16589R (1) 07-5-16589R (2) 07-5-16589R (3) 07-5-16589R (4) 07-5-16589R (5)
i
07-5-16589R (6) 07-5-16589R (7) 07-5-16589R (8) 07-5-16589R (9) 07-5-16589R (10)
w OFWUIS MM4;
07-5-16589R(11) 07-5-16589R (12) 07-5-16589R (13) 07-5-16589R (14) 07-5-16589R(15)