OPHTE# /S S-3'7688 Harnett County Department of Public Health 23888
PERMIT # Z T3S(s / Operation Permit
0 New Installation peptic Tank nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: vo, a..l
Name: (owner) -Z,(JC SUBDIVISION /Lt-,- r e-,4 LOT #_
System Installer: Registration #
Basement with plumbing: ❑ Garage -' umber o Bedrooms
Type of Water Supply: ❑Community I Public ❑ Well Distance from well feet
System Type: s 641 V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must con°[a t a h Department 6 months prior to expiration for permit renewal.
This system has been installed in romplianre with applicable North Carolina General Statutes, Rules for Sewage treatment and Disposal, and all conditions of the Improvement Permit and lonshurnon Authomanon.
3
3> G
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 ❑ 1-1201-ine ❑ PWR Line
Following are the specifications for the sewapR disposal tem on the above captioned property.
Type of system: ❑ Conventional I� Other 25 /D/L%� Septic Tank: 1000 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 3 of each ditch ga feet ditches 3 feet ditches -17 inches
French Drain Required: linear feet
Authorized State Aunt L� —. �' _ /`/�.� _y Date I ` I I
15-5-37084 (1)
15-5-37084 (2)
15-5-37084 (3)
15-5-37084 (4)
15-5-37084 (5)
15-5-37084 (6)
15-5-37084 (7)
15-5-37084 (8)
15-5-37084 (11) 15-5-37084 (12) 15-5-37084 (13)
15-5-37084 (9)
15-5-37084 (10)