OP RHTE# I_ -S 38�I��Z
PERMIT #
Name: (owner) U
System Installer:`
Basement with plumbing: ❑ Garage
Type of Water Supply: ❑ Community
System Type:�_�
(In accordance with Table V a) /
This system has been installed in
I. Performance:
ll. Monitoring:
IN. Maintenance:
IV. Operation:
V. Other.
Harnett County Department of Public Health 24229
with aoolicable North
of
Operation Permit
❑ New Installation ❑ Septic Tank ❑ Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION
If
SUBDIVISION -41LOT # �
�Registration # jr
feet
Types V and VI Systems expire in S years.
Health Department 6 months prior to expiration for permit renewal.
and all conditions of the Imororement Permit
vuwg- ci
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 syste on the ove aptioned prop r .
Type of system: ❑ Conventional Other Septic Tank:./ �J gallons Pump Tank: � gallons
Subsurface No. of exact h ditch
G D width o depth ofZ2,
f
Drainage Field ditches of each ditch 3 feet ditches feet ditches inches
French Drain Required: Linear feet
Authorized Stat Date
ol
16-5-38113R (1) 16-5-38113R (2) 16-5-38113R (3) 16-5-38113R (4) 16-5-38113R (5)
i
16-5-38113R (6) 16-5-38113R (7) 16-5-38113R (8) 16-5-38113R (9) 16-5-38113R (10)
16-5-38113R (11) 16-5-38113R (12) 16-5-38113R (13) 16-5-38113R (14) 16-5-38113R (15)
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16-5-38113R(16) 16-5-38113R (17) 16-5-38113R (18) 16-5-38113R(19) 16-5-38113R (20)
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16-5-38113R (21) 16-5-38113R (22) 16-5-38113R (23) 16-5-38113R(24) 16-5-38113R (25)
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velm t4
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16-5-38113R (26) 16-5-38113R (27) 16-5-38113R (28) J 16-5-38113R (29) 16-5-38113R (30)
1
16-5-38113R (31) 16-5-38113R (32) 16-5-38113R (33) 16-5-38113R (34) 16-5-38113R (35)