OPHTE# 11--S-37870 Harnett County Department of Public Health 24036
PERMIT # 281.9IZ / 0 eration Permit
[?(New Installation Septic Tank Ex] Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION;.Bay
Name: (owner) % od4 044k-4ron SUBDIVISION 1 a)=,,z 2a2a LOT # Z
System Installer: Registration #
Basement with plumbing: ❑ Garage Y Number of Bedrooms Z
Type of Water Supply: ❑Community Cad Public ❑ Well Distance from well /V1yst!emts�exptre
System Type: Zo `F T. —� t
in S ye rs.
(In accordance with Table V a) 7 �� / Owner mus contact ent 6 months prior to a iration for permit renewal.
This system has been installed in compliance with applicable North Carolina General Statutes, Rules for ewagAresunend all conditions of the Improve ent Permit and Construction Authorization.
I. Performance:
If. Monitoring:
III. Maintenance:
IV. Operation:
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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.
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: ❑ Conventional LY Other 75` 121- A Septic Tank: 1006 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches Z of each ditch 12' feet ditches S feet ditches 24418 inches
French Drain Required: Linear feet
Authorized State
Date W -2S {
16-5-37870 (1)
16-5-37870 (2)
16-5-37870 (3)
16-5-37870 (4)
16-5-37870 (5)
16-5-37870 (6)
16-5-37870 (7)
16-5-37870 (8)
16-5-37870 (9)
16-5-37870 (11) 16-5-37870 (12) 16-5-37870 (13)
16-5-37870 (14)
16-5-37870 (10)