OP RHTE# 16—SS— 3%'Z55/t Harnett County Department of Public Health 24035
PERMIT # Z807-1 uperation I"ermn /
New Installation Q Septic Tank Q Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LO[ATIONA10-A-1-t—
Name: (owner) ANjusr t IISoEh SUBDIVISION LOT #
System Installer: Zij Registration #
Basement with plumbing: ❑ tarage ❑lumber of Bedrooms 3
Type of Water Supply: ❑ Community LJ Public ❑ Well Distance from well feet
System Type: M2 6— Cz"*4Tvpes V and VI Systems expire in S years.
(In accordance with Table V a) Owner�Health Department 6 months prior to expiration for permit renewal.
This system has been installed in complianu with applicable Noeh Carolina General Statutes, Rules for Sewage Tmannent and Disposal, and all conditions of the Improvement Pennn and construction nuthonuhon.
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PERMIT CONDITIONS:
I. Performance:
If. 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 -Boz
❑ Pump ❑ Alarm ❑
1-1201-ine ❑ PWR Line
Following are the
specifications for
the sewage disposal system on the above captioned property.
Type of system:
❑ Conventonal
C3� Other %S'ti 044)e UZt-- _ Septic Tank: 1000
gallons Pump Tank: gallons
Subsurface
No. of
exact length width of
depth of
Drainage Field
ditches
3 of each ditch feet ditches 3
feet ditches inches
French Drain Required: Linear feet
SNS
Authorized State Ag- � a Date
t
16-5-38259R (1)
16-5-38259R (2)
16-5-38259R (3)
16-5-38259R (4)
16-5-38259R (5)
16-5-38259R (6)
16-5-38259R (7)
16-5-38259R (11) 16-5-38259R (12)
16-5-38259R (8)
16-5-38259R (9)
16-5-38259R (10)