OP RHTE# 1*4- -3Q93 Harnett County Department of Public Health 23912
PERMIT # Zi'cr'� Operation Permit
D New Installation 0 Septic Tank 171 Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATIONS Zr3 c�
Name: (owner) �- = T.-- i'/< . t;__, SUBDIVISION LOT #
System Installer. Registration #
Basement with plumbing: ❑ Garage umber of Bedrooms
Type of Water Supply: ❑ Community Ea Public ❑ Well Distance from well feet
System Type: 7s"%47e2 "� �7" zG eyGsI! Types V and A Systems expire in S years.
(In accordance with Table V a) Own#W ontact Health Department 6 months prior to expiration for permit renewal.
been imntled in
and
PERMIT CONDITIONS:
I. Performance: System shall perform in accordance with Rule .1961.
H. 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 ❑ Pump ❑ Alarm ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sew a disposal system on the above captioned property.
Type of system: ❑ Conventional Other 7S'% Septic Tank: /500 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 1 of each ditch 500 feet ditches j feet ditches inches
French Drain Required: Linear feet
Authorized State A� /� E �'Date
v
1
f�
PERMIT CONDITIONS:
I. Performance: System shall perform in accordance with Rule .1961.
H. 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 ❑ Pump ❑ Alarm ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sew a disposal system on the above captioned property.
Type of system: ❑ Conventional Other 7S'% Septic Tank: /500 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 1 of each ditch 500 feet ditches j feet ditches inches
French Drain Required: Linear feet
Authorized State A� /� E �'Date
v
l w� ice+—�--•• � i � - � 4 -__ � '.
.•s -
15-5-36837R (11) 15-5-36837R (12) 15-5-36837R (13) 15-5-36837R (14) 15-5-36837R (15)
15-5-36837R (16) 15-5-36837R (17) 15-5-36837R (18) 15-5-36837R (19) 15-5-36837R(20)
15-5-36837R (21) 15-5-36837R (22) 15-5-36837R (23) 15-5-36837R (24)