OP RHTE#/a —t — 3y SfgZ Harnett County Department of Public Health 23874
PERMIT # 2190-7-25 Operation Permit
ld New Installation Tank
PROPERTY LOCATION. S3
Name: (owner)</vSe��CJi'eaz. 65 SUBDIVISION _
System Installer: Registration #
Basement with plumbing:❑.�/ umber of Bedrooms
Type of Water Su ply: ❑ Community L,J Public ❑ Well Distance from well feet
System Type: ru ,.ten i—a 7.6 ry_= e3 �/0-4?pc q and VI Systems
(In accordance with TA V a) Owner must contact Health Department 6 mr
has been installed in compliama with installed in applicabl{ North Carolina General Statutes, Rules for sewage Treatment andCarolina General Statutes, Rules for sewage Treatment and
PERMIT CONDITIONS
I. Performance:
H. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
C1
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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.
/Nitrification Line ❑ Repair ❑ Expansion
#
tion for permit renewal.
1J
int Permit and Canstmttion Authorization.
'A--j�t �cia�5 ?� � d—
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sew disp I system on the above caption property.
Type of system: ❑ Conventional Other sWto i'.c �k't C wa��tr Septic Tank: /006 gallons Pump Tank: /000 gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 3 of each ditch 10 0 feet ditches 3 '' feet ditches �a�I.._ inches
French Drain Reauired: — Linear feet
Authorized State AQere� _ Ic? llelllf— -7'—~ Date /-8—
14-5-34599R (1) 14-5-34599R (2) 14-5-34599R (3) 14-5-34599R (4) 14-5-34599R (5)
14-5-34599R (6) 14-5-34599R (7) E 14-5-34599R (8) 14-5-34599R (9) 14-5-34599R (10)
14-5-34599R (11) 14-5-34599R (12) 14-5-34599R (13) 14-5-34599R (14) 14-5-34599R (15)
14-5-34599R (16)