OP RHTE# ii - s-3gf►z2 Harnett CountyDepartment of Public Health 24188
f3
PERMIT# Z835 eraaton Pet
Newew / Installation Septic Tank Csd" Nitrification Line ❑ Repair El Expansion
PROPERTY LOCATION:5C-/H4 Rs�
Name: (owner) /&M/ (OAe5/57-06 L,a, SUBDIVISION �i ✓=_P.y►r LOT # -7_
System Installer: Registration #
Basement with plumbing: ❑ Garage ET Number of Bedrooms
Type of Water Supply: ❑ Community IIPublic ❑ Well Distance from well feet
System Type: 2-45% R24i., 7.,,,,e. Fs� C— 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.
This system has been installed in compliance with applicable Ronh Leedom beneml )[alums, Rules for lewage treatment and nuposal, and all comment of the Improvement remit and Lontructmn Authorization.
S
nN�'
N
ID
s' , IZ
.Y�
8
3Z
fN1<T, V£� (resz
c T
PERMIT CONDITIONS
I. Performance:
Il. Monitoring:
III. 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 ❑ _
Following are the specifications for the sewaQ� disposal system on the above ,,ed property.
Type of system: ❑ Conventional fJy Other 77� Sr %!v G Septic Tank
Subsurface No. of exact length width of
Drainage Field ditches 3 of each ditch a feet ditches _
H2OLine ❑
PWR Line
oo D gallons Pump Tank: gallons
depth of
feet ditches Z Z inches
French Drain Required: Linear feet
Authorized State Date /�/�
16-5-38112R (1) 16-5-38112R (2) 16-5-38112R (3) 16-5-38112R (4)
AND -
I
16-5-38112R (6)
16-5-38112R (5)
16-5-38112R (7) 16-5-38112R (8) 16-5-38112R (9)
16-5-38112R (10)