OPHTE#.//,- s—s85o3 Harnett County ^Department of Public Health 24238
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PERMIT# 85�v eration Per It /
New Installation Septic Tank Nitrification line ❑ Repair ❑ Expansion
PROPERTY LOCATIONi, 1 4e/ /h
Name: (owner) SUBDIVISION LOT
System Installer: Registration #
Basement with plumbing: ❑ Garage mber of Bedooms 3
Type of Water SElCo munry, Public 1-1 We Distance from well feet
System Type: �ti%� Types V and VI Systems expire in 5 yeah.
(In accordance with Tabill V a) Owner oust Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Carolina General Statutes, les for Sewaee Treatment ad and Distditions of the Improvement Permit and Construction Authorisation.
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I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
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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 ❑
Alorm ❑ H2OLine
❑ PWR Line
Following are the
specifications for
the sewa Isposal s st m on the above captioned property.
Type of system:
❑ Conventional
Other T'��
Septic Tank: 14949 O gallons
Pump Tank /db gallons
Subsurface
Drainage
No. of
exact length
' L90
3o
width of 2
3
depth of
SQL a
field
ditches
of each ditch feet
ditches feet
ditches to inches
French Drain Required: Linear feet
Authorized State A Date
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1
16-5-38383(11) 16-5-38383(12) 16-5-38383(13) 16-5-38383 (14) 16-5-38383(15)
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7-1:
1
l
16-5-38383(16) 16-5-38383(17) 16-5-38383(18) 16-5-38383(19) 16-5-38383(20)
16-5-38383(21) 16-5-38383(22) 16-5-38383(23) 16-5-38383(24) 16-5-38383(25)
1
-,..:
16-5-38383 (31) 16-5-38383 (32) 16-5-38383 (33) 16-5-38383(34) 16-5-38383 (35)