OPHTE# a
PERMIT #
Harnett County Department of Public Health
/Operation Pe It /
24239
Y New Installation Septic
Tank Q/Nitrification Line
❑ Repair ❑ Expansion
PROPERTY LOCATIO d/t G ,G46
Name: (owner) SUBDIVISION LOT # /L
System Installer:
Basement with plumbing: ❑ Garage n ber of Bedrooms
Type of Water Suppl : ❑ Co muniry L°J Pub c ❑ Well Distance from elf h� feet
System Type: Types V and VI Syst s expire in S years.
(In accordance with Table V a) r Owner st cgflntact Health Department months prior to expiration for permit renewal.
This system has been installed in compliance with a solicable Nor Carolina General Lotuses. Rule for SewaNe Treatmedt and Disposal, and a wnditions of the Improvement Permit and Construction Authorization.
PERMIT CONDITIONS:
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
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.
V. Other.
❑ —D -Box ElPump ❑ Alarm ❑ 1`1201-ine ❑ PWR Line
Following are the specifications for the sew a disposal matte, aboveJcaptlone property.
Type of system: ❑ Conventional Other 1aL urki Septic Tank: �_ gallons Pump Tank: gallons
Subsurface No. of zz exact length width of depth of Q
Drainage Field ditches .J of each ditch ('b0 feet ditches __. 3 feet ditches ZI inches
French Drain Requsred: Linear feet /
Authorized State A nt ;s Date /0—/Y—/(o
16-5-38513R (1)
16-5-38513R (6)
16-5-38513R (2)
16-5-38513R (7)
16-5-38513R (11) 16-5-38513R (12)
16-5-38513R (3)
16-5-38513R (8)
r .
16-5-38513R (13)
16-5-38513R (4)
16-5-38513R (9)
16-5-38513R (14)
16-5-38513R (5)
16-5-38513R (10)
16-5-38513R (15)