OP RHTE# is -s 3ro"�336Z Harnett County Department of Public Health 23837
PERMIT # Z Operation Permit
New Installation X Sektic Tank )< Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: KOas6a._
Name: (owner)iL-a%�q Pay kf \tsx)cN�% SUBDIVISION LOT #
System Installer: Lary S.ic,2ef:- Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms _L
Type of Water Supply: ❑ Community EJ Public X Well Distance from well S00 feet
System Type: � Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
[his system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
`,S 62a
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PERMIT CONDITIONS
I. Performance: System shall perform in accordance with Rule .1961.
Il. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ NOIN
If yes, see attached sheet for additional operation cc
IV. Operation:
V. Other.
maintenance and reporting.
❑
D -Box
❑
Pump ❑ Alarm ❑
H2OLine ❑ PWR Line
Following are the
specifications for
the sewage disposal system on the above captioned property.
Type of system:
El Conventional
X Other 1l
aL- �,P S Septic Tank 100 O
gallons Pump Tank: gallons
Subsurface
of
exact length width of
depth of
Drainage Field
ditches
of each ditch 'lO feet ditches 3
feet ditches % inches
French Drain Required:
�'--4oear
feet
Authorized State Agent v;;1& Date
71.
Central Carolina Holdings
11-41
Customer: 0369650001 / Larry Sharpes
Generator: NA / Not Applicable
Dest: DEST: CUSTOMER / Customer
Truck: LARRY SHAR
Comment:
Ticket: 856323
Date:11/6/2015
Time:14:42:16 - 15:00:29
Scale
Gross: 42740 lb Out Manual Wt
Tare: 22360 lb In Manual Wt
Net: 20380 lb
Origin Wastes & Sevices Quantity Unit Rate/Unit Amount
-------------------------------------------------------------------------------------------
NA / Not Applicable DFMT116/Drain Fill Material 10.19 TON $22.00/TN $224.18
Total Taxes: $15.69
Total Amount: $239.87
Weighmaster: Driver:
Libby Cameron
ltafed meets Poe Nc soed(Ncollon as
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SUNI1111loa lar Rock Aggrbgrate in Nitrification Fields.