OPHTE#Ao-9— 30G0/Z_ Harnett County Department of Public Health
PERMIT # Z / eratiu on Permit/
EO/ Newew 13/Installation ' Septic Tank d Nitrificati
PROPERTY LOCATION:5V/d'TL�.4IG�i
Name: (owner jC�"��-rte SUBDIVISION �l.�cn> S
System Installer:�h n2o711V3 Registration #
Basement with plumbing: ❑ Garage 0 Number of Bedrooms 3
Type of Water Supply: ❑ Community Ed Public ❑ Well Distance from well feet
System Type: Z8'2n 62�12ar U # —tT� Types V and VI System pire in S ye
(In accordance with Table V caner must contact Health Department months pri o ex
This system has been installed in com lance with)Rpliable North Carolina General Statutes, Rules for Sewage Treatment and Dispose and all
i
J
PERMIT CONDITIONS:
I. Performance:
ll. Monitoring:
III. Maintenance:
IV. Operation:
V. Other
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4b
i
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.
Line ❑ Repair ❑ Expansion
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LOT # �-
For ermit renewal.
❑
D -Box ❑
Pump ❑
Alarm ❑ M201-ine ❑ PWR Line
Following are the
specifications for the sew a disposal
system on the above captioned property.
Type of system:
Elfonventional f"Other
f/ ,rte—
Septic Tank: /( n rs gallons Pump Tank: / 006 gallons
Subsurface
No. of
Z
exact length
width of depth of
3 LY
Drainage Field
ditches
of each ditch feet
ditches feet ditches inches
French Drain Required: Linear feet
Authorized State Lo]w�Z_/f % Date -7-Z — I f
16-5-38012 (1) 16-5-38012 (2) 16-5-38012 (3) 16-5-38012 (4) 16-5-38012(5)
r-
6
16-5-38012 (6) 16-5-38012 (7) 16-5-38012 (8) 16-5-38012 (9) 16-5-38012 (10)
;�i&. V�,t
16-5-38012(11) 16-5-38012(12) 16-5-38012(13) 16-5-38012(14) 16-5-38012(15)
16-5-38012(16) 16-5-38012(17) 16-5-38012(18) 16-5-38012(19) 16-5-38012(20)
imp
6-5-38012 (22) 16-5-38012 (23) mm
16-5-38012(26) 16-5-38012(27) 16-5-38012(28) 16-5-38012(29) 16-5-38012 (30)
16-5-38012 (31)