OPHTE# /G -s— 38 Harnett County Department of Public Health 24233
PERMIT # ZS`6 Z /Operation Per It /
ew Installation Septic Tank E Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: dhj: ,77 .GO
Name: (owner) 5—Vyc :L/ /3VZ:1bg (g5 SUBDIVISION lhhiii e= -see LOT #
System Installer: Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms
Type of Water Supply: ❑Comm nity ❑+Public ❑ Well Distance from well feet
System Type: ZM1&—JK !ri — -R::z- Z2 -l4 Types V and VI Systems expire in S years.
(In accordance with Table— Va) caner must contact Health Department 6 months prior to expiration for permit renewal.
[his 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 Construction Authorization
PERMIT CONDITIONS:
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
t
ts.. t�—
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 -Boz ❑ Pump ❑ Alarm ❑
H2OLine ❑
PWR Line
Following are the
specifications for the sewa disposal
the abo a
systemcaptioned property.
Type of system:
[I Cis COther%
aan
Septic Tank: gallons
Pump Tank: gallons
Subsurface
Drainage Field
No. of
ditches 3
exact length
of each ditch QZS feet
width of
ditches �� feet
depth of
ditches inches
French Drain
Authorized
Linear feet
Date /v—S"--/4�
or
"o,_ ` a r
rz"
.
41
16-5-38761 (1) 16-5-38761(2) 16-5-38761 (3) 16-5-38761 (4) 16-5-38761 (5)
.4" 7t-112 NZfi
16-5-38761 (6) 16-5-38761 (7) 16-5-38761 (8) 16-5-38761 (9) 16-5-38761 (10)
16-5-38761 (11) 16-5-38761 (12) 16-5-38761 (13) 16-5-38761 (14) 16-5-38761 (15)
i
mml� m J .
16-5-38761 (16) 16-5-38761 (17) 16-5-38761 (18) 16-5-38761 (19) 16-5-38761 (20)
1
Ir
16-5-38761 (21) 16-5-38761 (22) 16-5-38761 (23) 16-5-38761 (24)