OP RNTE# ti�r"Osz Harnett County Department of Public Health 2 3 g g 5
PERMIT # Operation Permit
2'New Installation Septic Tank p'Nitrifiication Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:_/Aa '17—
Name:
zName: (owner) TLr --WAscv A147,J:c -1. SUBDIVISION LOT #
System Installer: o Registration #
Basement with plumbing: ❑ Garage 2"Nurnier of Bed ooms '_
Type of Water Supply: ❑ Community QrPublic ❑ Well Distance from well feet
System Type: T Types V and VI Systems expire in 6 years.
(In accordance with Table V a) Owner mustrc�(1aT�alth-Department 6 months priorlto expiation for permit renewal.
This system has been installed in compliance with applicable North Cailelina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of
PERMIT CONDITIONS
I. Performance:
ll. Monitoring:
III, Maintenance:
IV. Operation:
V. Other.
ja'rct ✓wl tell Ln>
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 ❑
Construction Authorization,
Following are the specifications for the sew disposal system on the above captioned property.
Type of system: ❑ Conventional sew
li-% //� the
rl r _ Septic Tank: 4 Lo J gallons Pump Tank:
Subsurface No. of exact length width of depth of
Drainage Field ditches I of each ditch 350 feet ditches 3 feet ditches Z7
French Drain Required: Linear feet
Authorized State Age!!�� /' r �,�1 l,lwks*, j'� Date ! — ❑ —! /
PWR Line
gallons
inches
15-5-36609R (1)
15-5-36609R (6)
15-5-36609R (2)
15-5-36609R (7)
15-5-36609R (3)
15-5-36609R (4)
15-5-36609R (5)
5
Al
H I
y�
15-5-36609R (8) 15-5-36609R (9) 15-5-36609R (10)
15-5-36609R (11) 15-5-36609R (12) 15-5-36609R (13) 15-5-36609R (14) 15-5-36609R (15)