OPHTE# i�-s 3s�9 Harnett County Department of Public Health 24202
PERMIT # Z$$Zo / Operation Per(nit
d New Installation E`'1 Septic Tank � Nitrification Line F-1Repair❑ Expansion
PROPERTY LOCATION:,TX/VV l
Name: (owner) !ur s _mac SUBDIVISION R4-/ r~-b� 5- LOT # / 9F
System Installer. 0 azu>� Registration #
Basement with plumbing: ❑ Garage umber of Bedrooms
Type of Water Supply: ❑ Community R Public ❑ Well Distance from well feet
System Type: ZS'Z &X 5esi T .� air C9+r-0 �_ Types V and A Systems expire in S years.
(In accordance with Table V a) Owner mu , tact 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 Lonstrumon numunzat ni.
it
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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 -Box ❑
Pump ❑
Alarm ❑ H20Line ❑ PWR Line
Following are the
specifications for the sewagt disposal
system on the above captioned property.
Type of system:
❑ Conventional C9 Other 71`i,
t76T'-j
Septic Tank so o gallons Pump Tank gallons
Subsurface
No. of
exact length
width of depth of
Z
Drainage field
ditches
of each ditch 3 OO feet
ditches feet ditches inches
French Drain Required: Linear feet
Authorized State ((Rent `_,t'"ri-a----> l / 1 Date f - 7 -
16-5-38099 (1)
Aft
16.5.38099 (6)
16-5-38099 (2)
16-5-38099 (7)
16-5-38099 (11) 16-5-38099 (12)
16-5-38099 (3)
16-5-38099 (4) 16-5-38099 (5)
� _ 1
16-5-38099 (8)
16-5-38099 (9) 16-5-38099 (10)
16-5-38099 (1)
16-5-38099 (2)
16-5-38099 (3)
16-5-38099 (4) 16-5-38099 (5)
16.538099 (6)
16-5-38099 (7)
16.5-38099 (11) 16-5-38099 (12)
16-5-38099 (8)
16-5-38099 (9) 16-5-38099 (10)