OPHTE# 110 -5- 43{- Harnett County Department of Public Health 24204
PERMIT # 2R>P,4�5- Operation Permit
O New Installations E Septic ie tpS c Tank E2 Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOLATIONk5K,19 /Ff
Name: (owner) Z e � - �� SUBDIVISION /i%WL,dS izn&> LOT #
System InstallerRegistration #
Basement with plumbing:❑/ umber of Bedrooms
Type of Water SuDDI, .. ❑ Community (7 Public ❑ Well Distance from well feet
System Type: 7, /6 641)c+�Cr'��,�, -p-(� 111 V and VI Systems expire in S years.
(In accordance with Table V a) r t' Owner must contact H alth Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Carolina General Statutes. Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Constmcnon Authonzalton.
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PERMIT CONDITIONS
I. Performance:
II. 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 -Boz ❑
Pump ❑
Alarm ❑ 1-1201-ine ❑ PWR Line
Following are the
specifications for the sewage disposal
system on the above captioned property.
Type of system:
❑ Conventional ®" Other I�;
L�YLw.�Ssrl+4._
Septic Tank: / ;70 b gallons Pump Tank gallons
Subsurface
Drainage Field
No. of 2
ditches J
exact length 7
of each ditch / 0 0 feet
width of depth of
ditches - feet ditches � inches
French Drain Required: Linear feet
Authorized Stateent/ �` `> A�/lf�—ft��sz %�� Date — —!
16-5-38436 (1)
16-5-38436 (2)
16-5.38436 (6)
16-5-38436 (7)
16.5-38436(11) 16.5-38436(12)
16-5-38436 (3)
�Y
16-5-38436 (8)
16-5-38436 (4)
AI' r
16-5-38436 (5)
16-5-38436 (9)
16.5-38436 (10)
W F
Q
16-5-38436 (1) 16-5-38436 (2)
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16-5-38436 (3)
16-5-38436 (6)
16-5-38436 (7)
16-5-38436 (8)
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f
16-5-38436 (4) 16-5-38436 (5)
I.
16-5-38436 (9)
16-5-38436 (10)
h
16-5-38436 (11)
16-5-38436(12)
16-5-38436 (8)
-'S= :a
f
16-5-38436 (4) 16-5-38436 (5)
I.
16-5-38436 (9)
16-5-38436 (10)