OP RHTE# B -S 5ZD-Q Harnett County Department of Public Health 23866
PERMIT # azT036 Operation Permit
( New Installation Se tic Tank Nitrification Line El Repair F-1Expansior
PROPERTY LOCATION: n' T(2.sPaOtsa 6 C".;
Name: (owner) Qiig� �e tNso r koi LLC— SUBDIVISION M Prx;YrnVLPr,6, LOT # -%7
System Installer: F-Do - E ( w rEn Registration #
Basement with plumbing: ❑ Garage `k' Number of Bedrooms 4
Type of Water Supply: ❑ Community Iq Public ❑ Well Distance from well tb o feet
System Type: 1 i Types V and A Systems expire in 5 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 North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
PERMIT CONDITIONS
I. Performance: System shall perform in accordance with Rule .1961.
ll. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ No
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
❑ —D -Box ElPump ❑ Alarm ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sewage disposal system on the abovg caption property.
Type of system: ❑ Conventional T Other �riAt+�4 CTL `Q1:�J Septic Tank: WCQ gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field dit Tes of each ditch 2,�k O feet ditches feet ditches Pt 30 inches
French Drain Required• ear feet
Authorized State Aeent `Al Date
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PERMIT CONDITIONS
I. Performance: System shall perform in accordance with Rule .1961.
ll. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ No
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
❑ —D -Box ElPump ❑ Alarm ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sewage disposal system on the abovg caption property.
Type of system: ❑ Conventional T Other �riAt+�4 CTL `Q1:�J Septic Tank: WCQ gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field dit Tes of each ditch 2,�k O feet ditches feet ditches Pt 30 inches
French Drain Required• ear feet
Authorized State Aeent `Al Date
1ti,-S-3ys);va-