OP RRHTE# llo'S 5823LZ+Z Harnett County Department of Public Health 24181
PERMIT # ?—%-7 Operation Permit
C?New Installation 2T Septic Tank Q–Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOICATION: AY 4k-131
Name: (owner)SUBDIVISION LOT # e—
System Installer. l� W Registration #
Basement with plumbing: ❑ Garageumber of Bedrooms 3
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: o f17 G t� L ri Types V and VI Systems expire in 5 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 North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
PERMIT CONDITIONS
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. 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 ❑
H2DLine ❑ PWR Line
Following are the
specifications for
the sdisposal system on the above captioned property.
ewa
Type of system:
ElConventional
Other 7.5% Fad 10:" G Septic Tank: 1 e4)0
gallons Pump Tank: gallons
Subsurface
No. of
exact length width of 2
depth of
a
Drainage Field
ditches
L of each ditch FSO feet ditches 3
feet ditches ZD inches
French Drain Required: Linear feet
Authorized State Date /Z / 62
16-5-16-5-38232RR (1) 16-5-16-5-38232RR (2) 16-5-16-5-38232RR (3) 16-5-16-5-38232RR (4) 16-5-16-5-38232RR (5)
.Z
16-5-16-5-38232RR (6) 16-5-16-5-38232RR (7) 16-5-16-5-38232RR (8) 16-5-16-5-38232RR (9) 16-5-16-5-38232RR (10)
Ono
16-5-16-5-38232RR (11) 16-5-16-5-38232RR (12) 16-5-16-5-38232RR (13) 16-5-16-5-38232RR (14) 16-5-16-5-38232RR (15)
9CI ,
Ir C„
�'-IS
16-5-16-5-38232RR (16) 16-5-16-5-38232RR (17)