OPHTE# 15"5 P A)3 Harnett County Department of Public Health 23867
PERMIT # 2Q�1`G Operation Permit
New Installation )R Septic Tank )>-Z Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: VNx0,VAX DM%-4Fw
Name: (owner) �EoayFSL \Nov.r—s LLC. SUBDIVISION P s41c+waN crQc bStralrg" LOT # 2s
System Installer: Ov5 as ->7 erL\oc. -N*aD Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms
W
Type of Water Supply: ❑ Community Public ❑ Well Distance from well LQ O feet
System Type: � K Types V and VI Systems expire in S 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
PERMIT CONDITIONS
I. Performance:
II. Monitoring.
111. Maintenance:
IV. Operation:
V. Other:
i stirAlQ �
1
1
1
i
Li
P
'tt
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 ❑ 4201-ine
❑ PWR Line
Following are the
specifications for the
sewage disposal system on the above captioned property.
Type of system:
❑ Conventional
1K Other E Z
Septic Tank: 10700 gallons
Pump Tank: gallons
Subsurface
No. of
exact length
width of
depth of
Drainage field
hes t
of each ditch 30o feet
ditches _ feet
ditches inches
French Drain ReeuiretL
Linear feet
Authorized State Agent '��� ftA)f Date [Y
15-5 7LA-,5
Zf M
g