OPNTE# 3728/ Harnett County Department of Public Health 23908
PERMIT # Z65-84 Operation Permit
C�New Installation Septic Tank Eq-INitrificatian Line ❑ Repair ❑Expansion
PROPERTY LOCATION: We lArZ;=,Us ,C-0
Name: (owner) .a� I�iCS / ! ,v SUBDIVISION V. `/x, v. ceyle-r LOT # 1IV
System Installer: Registration #
Basement with plumbing: ❑ Garage ffAumber of Bedrooms q
Type of Water Supply: ❑ Community E?f Public ❑ Well Distance from well feet
System Type: % w — pes—Pan ystems expire in S years.
(In accordance with Table V a) Owner must con Health Depa)tment 6 mthe prior to expiration for permit renewal.
IV
This system has been installed in compliance with applicable North'Carolina General Statutes, Rules for Sewage eatmen nd Disponk and at con itions of the Improvement Permit and Construction Authorization.
I. Performance:
ll. Monitoring:
III. Maintenance:
IV, Operation:
V. Other.
4-- --;?-4'
A--T`-KZ-As V C(t < cT--
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
❑ PWR Line
Following are the
specifications for
the sewage disposal system on the above captioned property.
Type of system:
El Conventional
LY Other 25% @aftuZ --s I �—
Septic Tank: / ° �y gallons
Pump Tank.. gallons
Subsurface
No. of
exact length
width of
depth of
Drainage Field
ditches
±> of each ditch /00 feet
ditches 3 feet
ditches 2% inches
French Drain Required: Linear feet
Authorized State Agoat— ! .- Date
, 7�c
'ap V
15-5-37281(l)
15-5-37281 (2) 15-5-37281 (3) 15-5-37281 (4)
15-5-37281(5)
15-5-37281(6)
15-5-37281 (7)
15-5-37281 (8)
15-5-37281 (9)
15-5-37281(11) 15-5-37281(12) 15-5-37281 (13)
15-5-37281 (14)
15-5-37281 (10)