OPHTE# Yom- S'- 34'M 7 Harnett County Department of Public Health 24034
PERMIT # Z S Oto -7 Operation Permit
E3" New installation Tank R7 Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:&
Name: (owner) '. Zq d-tLJ� LuA<A7S SUBDIVISION li��.n.�3 LOT #
System Installer: os C*44,c� Registration #
Basement with plumbing: ❑ Garage R�Jumber of Bedrooms 3
Type of Water Suppply: ❑ Community Ltl Public ❑ Well Distance from well feet
System Type: ZS'/, 1Z&Wteu>3 k-- G Types V and VI Systems expire in S years.
(In accordance with Table V a) Owner must co tact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with
PERMIT CONDfTIONS:
I. Performance:
If. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
Rules for Sewaee Treatment and Disposal and all conditions of the Improvement Permit and
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 cc
and
❑ D -Box ❑ Pump ❑ ✓' fbYb(m ❑ 1-12O1-ine ❑ PWR Line
Following are the specifications for the sew a disposal system on the above captioned property.
Type of system: El Conventional sew
Septic Tank i cao d gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch ` feet ditches 3 feet ditches _2— 2� inches
French Drain Reouired: Linear feet
Authorized State A¢el�r✓�—�� Date L)' "I b
i 1
15-5-36497 (1) 15-5-36497 (2) 15-5-36497 (3) 15-5-36497 (4) 15-5-36497 (5)
wl
15-5-36497(6) 15-5-36497(7) 15-5-36497(8) 15-5-36497(9) 15-5-36497 (10)
15-5-36497(11) 15-5-36497(12) 15-5-36497(13) 15-5-36497(14) 15-5-36497(15)