OPHTE# 15-5-3-73) Harnett County Department of Public Health 24006
PERMIT # Operation Permit
X New Installation �K Septic Tank X Nitrification Line ❑ Repair EI Expansion
r PROPERTY LOCATION: �au Lvcvas Po
Name: (owner) P6' C, SUBDIVISION S w C.0 w NKC9— LOT # 41
System Installer: " s v SSg7i L Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms 31
Type of Water Supply: ElCommunity X Public ❑ Well Distance from well ip0 feet
System Type: a Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
this system has been Installed in compliance with applicable North Carolina General Statutes,. Rules for Sewage Treatment and Disposal, and all mndidons of the Improvement Permit and construction Authorization
PERMIT CONDITIONS
I. Performance:
If. Monitoring:
III. Maintenance:
IV. Operation:
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 ca
�f I
I P4� t
f
I 1
kovsL
D
a
l
E
maintenance and reporting.
V. Other.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional X Other G Z Fs.pw Septic Tank: TO(Z6 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches I_ of each ditch 300 feet ditches 3 feet ditches 210-34 inrhes
French Drain Required: Linear feet
Authorized State Agent y Date Z4 Ib
TC
A t
4f� °
)
aY <.
s:.
KTRY y3'.k
Zyy.Y'L g