OPHTE# Harnett County Department of Public Health 24182
PERMIT # 28?'5 Operation Permit
2 New Installation COY Septic Tank 21'litrifiwtion Line ❑ Repair ❑ Expansion
PROPERTY LO(ATIONZrtjli / 2A�t�✓
Name: (owner) 72:L1<!a SUBDIVISION A LOT #
System Installer: Co-.> lc,; .-� a� Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms 3
Type of Water Supply: ❑ Community ❑ Public L2' Well Distance from well I dpo"s" feet
System Type: 2!`e0? -4A& -c. '3M G ¢Z C.4ei 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.
[his system ha been installed in compliance mth applicable North Carolma General Statutes, Rules tar Sewage treatment and Disposal, and all conditions o[ the Improvement Permit and Construction Authorization
PERMIT CONDITIONS
I. Performance:
11. Monitoring:
111. Maintenance:
IV. Operation:
Other.
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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.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sew disposal system on the above captione_,property.
Type of system: ❑ Conventional Other ZS�a f2�slw G7o-`l LLQ �z — 9@ptic Tank I u o t) gallons Pump Tank. gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 2 of each ditch 150 feet ditches j feet ditches L2-)13 inches
French Drain Required: Linear feet
AL2..
Authorized State A rat Date -7—r2 r/(.
16-5-38506 (1)
�yd•s
16-5-38506 (2)
16-5-38506 (6) 16-5-38506 (7)
16-5-38506 (11)
16-5-38506 (12)
Ig six
MAI
16-5-38506 (3) -�
�r
16-5-38506 (8)
16-5-38506 (13)
Jim
!' l.i��• t f Y
16-5-38506 (4)
16-5-38506 (5)
16-5-38506 (9)
16-5-38506(10)
16-5-38506 (14)
16-5-38506 (15)
16-5-38506 (16) 16-5-38506 (17)
16-5-38506 (18)
16-5-38506 (19)
16-5-38506 (20)