OPHTE#1%-5 - 379 7 Harnett County Department of Public Health 24033
PERMIT# — Operation Permit
L3/ New Installation Septic Tank C3/ Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LO(ATION: Iltu !% q
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Name: (owner) Y� � ! SUBDIVISION C.le_1J�Mg'\) rA7vr.-0 LOT # q
System Installer: '7l X1,,4,Registration #
Basement with plumbing: ❑ Garage -umber of Bedroom 3
Type of Water Supply: ❑ Community f� Public ❑ Well Distance from well feet
System Type: ??P `k /b&hV- rt�., AokS-75.¢ 6 and VI Systems expire in S years.
(In accordance with Table V a) Owner must contact Nealt Department 6 months prior to expiration for permit renewal.
This system on been•inualed in compliance with applicable North Carolina General Statures, Rules for sewage Treatment and Disposal, and all candivons of the Improvement Permit and construction Authorization.
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PERMIT CUNDITIUNN:
I. Performance:
II. 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 sew?8e disposal system on the above captioned property.
Type of system: ❑ Conventional C�1 Other 15%0-^UG1 -- 5a 2+,Z.— Septic Tank: /00 D gallons Pump Tank: gallons
Subsurface No, of f' exact length width of depth of It
Drainage Field ditches of each ditch feet ditches 3 feet ditches I & inches.
French Drain Required: Linear feet
Authorized Stateens ' J � Date
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16-5-37857 (1) 16-5-37857 (2) 16-5-37857 (3) 16-5-37857 (4) 16-5-37857 (5)
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16-5-37857 (6) 16-5-37857 (7) 16-5-37857 (8) 16-5-37857 (9) 16-5-37857 (10)
16-5-37857 (11) 16-5-37857 (12) 16-5-37857 (13) 16-5-37857 (14) 16.5-37857 (15)
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16-5-37857 (16) 16-5-37857 (17) 16-5-37857 (18) 16-5-37857 (19) 16-5-37857 (20)
16-5-37857 (21)