OPHTE# tt.-s-3azz4 Harnett County Department of Public Health
24049
PERMIT # Z a9T Operation Pe it
E/ New Installation Septic Tank C3/
Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION;j7-7 AW' Sd-
Name; (owner) .sTF?ff/an) % /yL_/y4>, SUBDIVISION LOT # -AV
System Installer: C-+2,�Qe.xi--s Registration #
Basement with plumbing: ❑ Garage 51'51umber of Bedrooms '13Type of Water Supply: El Community Lid" Public ❑ Well Distance from well feet
System Type: DV COUN expire in S years.
(In accordance with Table V a)0 (must c^an gKealth Department months prior to expiration for permit renewal.
This mtem h. been :.,taped in mmnlianfe with annf.bl. Nwh rnlim Genrhl fmt c Rnld rnr r..'i' �msnr eM nimmal 2nd rnnAirinm ml rhe Imn.wem.nr Psrmir -A fnn.mvrinn
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VtKMII LUNUIIIUN):
I. Performance:
II. Monitoring:
111. 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 -Box ❑ Pump ❑ Alarm ❑
M20Limo ❑
PWR Line
Following are the specifications for the sew a disposalstist�� above captioned property.
Type of system: ❑ Conventional _Other v >/ :��_) Septic Tank: DDZ> gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch 7s feet ditches 3 feet ditches inches
French Drain Required: Linear feet
Authorized State nt Date 7—ZZ —/0
V
16-5-38222 (1) 16-5-38222 (2) 16-5-38222 (3) 16-5-38222 (4) 16-5-38222 (5)
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16-5-38222 (6) 16-5-38222 (7) 16-5-38222 (8) 16-5-38222 (9) 16-5-38222 (10)
16-5-38222 (11) 16-5-38222 (12) 16-5-38222 (13) 16-5-38222 (14) 16-5-38222 (15)
16-5-38222(16) 16-5-38222(17) 16-5-38222(18) 16-5-38222(19) 16-5-38222(20)
16-5-38222(21) 16-5-38222 (22)