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OP RR
HTE# 10-5-Q Harnett County Department of Public Health 24000 PERMIT # 9-8W1 Operation Permit XNew Installation �K Septic Tank 'Ixl� Nitrification Line ❑ Repair ❑ Expansion PROPERTY LOCATION: ami C." Q.n, Name: (owner) N�Nczycn\cl6 L SUBDIVISION LOT # System Installer: L--AQA-t, StiAa.P6 Registration # Basement with plumbing: ❑ Garage Number of Bedrooms _ t Type of Water Supply: ❑ Community Public ❑ Well Distance from well 100 feet System Type: --=Z3M f_ Types 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. Inn sa9em nas oeen discuses In Compliance wnn PERMIT norm stations Denial arid all Conditions of the Improvement Permit and Consuumon Authorization. 1 30 E7I Asn vsE --] IT o laoc sz 40 W I. Performance: System shall perform in accordance with Rule .1961. 11. Monitoring: As required by Rule .1961. 111. 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 ❑ H2OLine ❑ PWR Line Following are the specifications for the sewage disposal system on the above captioned property. Type of system: El A Other—iiti-M �1P5 Septic Tank: 10©0 gallons Pump Tank gallons Subsurface No. of exact length width of depth of Drainage Field ditches of each ditch 110 feet ditches .31— feet ditches QL1 inches French Drain Required, --, ' ea Authorized State Agent -�dzsailee'riS Date I©— s-Qa— ;fin � d T, 1 � t< Central Carolina Holdings Customer: 0369650001 / Larry Sharpes Generator: NA / Not Applicable Dest: DEST: CUSTOMER / Customer Truck: LARRY SHAR Comment: Ticket: 954113 Date:4/18/2016 Time:13:21:11 - 13:46:20 Scale Gross: 43280 lb Out Manual Wt Tare: 22340 lb In Manual Wt Net: 20940 lb Origin Wastes & Sevices Quantity Unit Rate/Unit Amount ------------------------------------------------------------------------------------------ NA / Not Applicable DFMT116/Drain Fill Material 10.47 TON $22.00/TN $230.34 Total Taxes: $16.12 Total Amount: $246.46 Weighmaster: Driver: Libby Cameron : ,.teW3 th-, Ne saeNtieallon as k 371UtilG t^ k G , h r.' 2-0sR for has udp