OPHTE# I5 -S -7 OGS Harnett County Department of Public Health 23847
PERMIT # ��53� Operation Permit
New Installation _IN� Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:
Name: (owner) Y c GE "omF_:s Lt C, SUBDIVISION <2)P s tai LOT # 5
System Installer: Cao, . G vrL s s ec-L- Registration #
Basement with plumbing: ❑ Garage 19 Number of Bedrooms L-)
Type of Water Supply: ❑ Commi Public ❑ Well Distance from well S Q feet
System Type: aim" Types V and A Systems expire in S years.
(In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable Nonh Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authoritarian
1 ii0 v:b�
CL r V6
C9 L_tj
PERMIT CONDITIONS
1. Performance: System shall perform in accordance with Rule .1961.
II. Monitoring: As required by Rule .1961.
111. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ NSiX
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
❑
D -Boz
❑ Pump ❑ Alarm ❑
H2OLine ❑ PWR Line
Following are the specifications for
the sewage disposal system on the above ;a boned mperty.
Type of system: El
Other Csaaw�F3H1 C�T� Septic Tank: sbo6
gallons Pump Tank: gallons
Subsurface
Na. exact length width of
depth of
)� 3ri
Drainage Field
ditches
of each ditch 300 feet ditches
feet ditches taches
French Drain Required:
�_
feet
Authorized State Assent ��� "r -'s Date