OPNTE#jto— S— 3M1. Harnett County Department of Public Health 24177
PERMIT # ZSfiBI Operation Permit
❑ New Installation ❑ Septic Tank Nitrification Line ❑ Repair Expansion
PROPERTY LOCATION:Z/-/syd 14zns� itz
Name: (owner) C—tA.+; 146vgt — SUBDIVISION LOT # 5
System Installer: D*�-sTti4-"Abls Registration #
Basement with plumbing: ❑ Garage ❑J Number of Bedrooms 3
Type of Water Supply: ❑Community L'J Public ❑ Well Distance from well feet
System Type: tZAbts —Types V and VI Systems expire in S years.
(In accordance with Table V a) Owner must con st Health =all
r to expiration for permit renewal.
This system has been installed in remoliana with aooliable North Carolina Gene trey 151ok�s for waee Treatment andhe Improvement Permit and Constroction Authorization.
I. Performance:
It. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
Ov 'r- M art_ 1" o i, " " - Xlta
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 ❑ H2OLine
❑ PWR Line
Following are the
specifications for
the sewa�e disposal syatem on the above captioned property.
Du
_
Type of system:
El Conventional
13 Other Z5 /u n$ t ruj. ,
Septic Tank: gallons
Pump Tank: gallons
Subsurface
No. of
exact length
width of
depth of
Drainage Field
ditches
Z of each ditch aSo feet
ditches 3 feet
ditches Z Zea inches
French Drain Required:
Linear feet
Authorized State A(aLe?5�1� C /" I /4a t i t -*'Sl Date I - 1 —
1 ��
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