OPHTE# /S-S-3-7ceT Harnett founty Department of Public Health 24025
PERMIT # Z8GS7 Operation Per It
137 New Installation Septic Tank E2 Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOfATI01L�siui r cue. /c �/,4riCC•�L /d1S
Name: (owner)f 7�G SUBDIVISION bd X LOT #
System Installer:/Zv S�tf I�f Ltc s Registration #
Basement with plumbingEl Garage Number of Bedrooms 3
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: Z5% " cscrz,ya. E,3� �/z< r G +1 ixues 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.
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 Construttion Authorization.
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I. Performance:
ll. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
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 ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sewa a disposal system on the above captioned property.
Type of system: ❑ Conventional 70ther 7S� Obv4toti Septic Tank b/ 20 gallons Pump Tank: gallons
Subsurface No. of exact length f5 width of depth of 11''
Drainage Field ditches of each ditch O feet ditches 3 feet ditches inches
French Drain Required: Linear feet
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Authorized State tt C-"
" • �" "(�f ik"—� Date
15-5-37454 (1)
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15-5-37454 (6)
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15-5-37454 (11)
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Y
15-5-37454 (16)
15-5-37454 (2)
15-5-37454 (7)
15-5-37454 (3)
Ma�x^a r.
15-5-37454 (4)
15-5-37454 (8) 15-5-37454 (9)
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15-5-37454 (5)
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Y
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15-5-37454 (10)
15-5-37454 (12)
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15-5-37454 (17)
15-5-37454 (13) 15-5-37454 (14)
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15-5-37454 (18)
15-5-37454 (15)