OPHTE#Harnett County Department of Public Health 24119
PERMIT #gto�733 Operation Permit
New Installation .X Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION`. Dbc-js Ep
Name: (owner) � � r i-� C�a majWa-5 SUBDIVISION Q)P94tnoA.1— LOT # S
System Installer: On as Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms i•
Type of Water Supply: ❑ Community {� Public F-1WellDistance from well l00 feet
System Type: J.J�LO� 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 applitable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and tomtmCnon Aumonxanon.
l00
�,L �S•
t�
acO �
NUUSE
l
I
I
C_
H �oP Oq-_
PERMIT CONDITIONS:
I. Performance:
11. 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 ❑ N
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
❑ D -Box
❑ Pump Cl
Alarm ❑ H2OLine
❑ PWR Line
Following are the specifications for
the sewage disposals stem on the above captioned property.
Type of system: El Conventional
A Other �a � 0
Septic Tank 1000 gallons
Pump Tank gallons
Subsurface No. of
Drainage Field ditc
exact length
of each ditch 15 O feet
width of
ditches— feet
depth of
ditches �� �+d inches
French Drain Required:
Ung feet
Authorized State hent
p4 S
Date gl9sl'r-