OPHTE# &-s Harnett County Department of Public Health 24217
PERMIT# ZB96Aeration Per •t
ZNew Installation Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATIONS q(/A /&AVrS.46
Name: (owner) O+ u SUBDIVISIONJ¢TI:rN fit LOT #
System Installer. AVAQr5 / Registration #
Basement with plumbing: ❑ Garage tuber of Bedrooms _
Type of Water Su�p }I : ❑ Community Public ❑ Well Distance from well feet
System Type: 77�%lLYrr �" s �ht2Tr' ypes V and VI Systems expire in S years.
(In accordance with Table V a) Owner must cont9t Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Carolina General Stances, Rules for Sewage Treatrmnt and Disposal, and all conditions of the Improvement Permit and Construction Aunonaato n.
'A.
34
F tiCa' S
vritit r
ornrmt rnumnnuc.
I. Performance:
11. Monitoring:
Ill. 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 ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewa$�'disposal system on the above captioned property.
Type of system: ❑ Conventional 13 Other '11C* Septic Tank: / WV gallons Pump Tank: gallons
Subsurface No. of exact length width of �y depth of
Drainage Field ditches of each ditch � feet ditches wJ feet ditches inches
French Drain Required: Linear feet
Authorized State Ae to �a 2 �i.9� �L s� f1���a'� Date Ji— 1 2 — &
16-5-38587 (1)
16-5-38587 (6)
16-5-38587 (2) 16-5-38587 (3) 16-5-38587 (4) 16-5-38587 (5)
K
16-5-38587 (7) 16-5-38587 (8) 16-5-38587 (9) 16-5-38587 (10)
16-5-38587 (11) 16-5-38587 (12) 16-5-38587 (13)