OPHTE# K9'S 3'0:.5'5 Harnett County Department of Public Health 24225
PERMIT # ZS$ G Operation Permit
LY New Installation C'Septic Tank Q Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: 06c 1VVV A _Z!* 44-0
Name: (owner) ,Q�f�S �Q� SUBDIVISION _.41f�1�� r/�GC.�. r_ LOT # /Z
System Installer:- r-% Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms If
Type of Water Sypply: ❑ Community Public ❑ Well Distance from well feet
System Type: I—]U d—e ] tf`dz trcQ T ZIPS 4— 3 4Fz.Z iTypes V and VI Systems expire in S years.
(In accordance with able V a) Owner must cont t Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Carolina General Statures, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and lonsnuion Authonaanon.
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PERMIT CONDITIONS
I. Performance:
Il. Monitoring:
III. Maintenance:
IV. Operation:
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 sews disposal system on the above captioned property.
Type of system: ❑ Conventional Eor Other L67 ) Aep zr3 "WO Septic Tank: / &-tJ gallons Pump Tank 14De gallons
Subsurface No. of exact length �— width of depth of
Drainage Field ditches 3 of each ditch _� '� feet ditches 3 feet ditches Z Z inches
French Drain Required: Linear feet
Authorized State Agen Date % — 14,
16-5-38659 (1)
16-5-38659 (2)
16-5-38659 (3)
16-5-38659 (4)
16-5-38659 (5)
16-5-38659 (6)
16-5-38659 (7)
16-5-38659 (8)
16-5-38659 (9)
16-5-38659 (11) 16-5-38659 (12) 16-5-38659 (13)
16-5-38659 (14)
16-5-38659 (10)