OPHTE# &&n =397j Harnett County Department of Public Health 2424
PERMIT # Operation Per It Z
G� New Installation Septic Tank CJ,' Nitriffcatior Line ❑ Repair El Expansion
PROPERTY LOCATION: v/
Name: (owner) SUBDIVISION 6T #_
System Installer: / Registration #
Basement with plumbing: ❑ Garage r�,,a,',be cf Bedrooms
Type of Water Supply: ❑ Community fJ' Public ❑ Well Distance from well feet
System Type:dZ,5 Z
(In accordance with Table V a)
This system has been installed in compliance with
I. Performance:
If. Monitoring:
III. Maintenance:
IV. Operation:
Other.
- Owner must contact Health
Q 44✓'
Carolina General statutes. Rules for Sewer a anewrin
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other.
VI Systems expire in S years.
:ment 6 months prior to expiration for permit renewal.
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting
of the Improvement Permit and Construction
❑
D -Box ❑
Pump ❑
Alarm ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sewa Isposal
system on the above captioned property.
Type of system: El
Conventional Other 7Se'�,/is�
Septic Tank: 1060 gallons Pump Tank: /10 gallons
Subsurface
Drainage field
No. of
ditches _
exact length
of each ditch 6p feet
width of2 depth of
ditches 3 feet ditches 7 (2—)Ia inches
French Drain Required:
Linear feet
Authorized State Ag nt �� � Date 1D'�i:N-IV
�• [(�.P � r G � ,�v; �'y�S III j�
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1 .r
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16-5-38799 (1)
16-5-38799 (2)
16-5-38799 (3)
_ •... •(.-_moi,
16-5-38799 (4)
16-5-38799 (5)
16-5-38799 (6)
16-5-38799 (7)
16-5-38799 (8)
16-5-38799 (11)
16-5-38799(16)
16-5-38799 (12)
16-5-38799 (17)
16-5-38799 (13)
16-5-38799(9) 16-5-38799 (10)
7WOA
•R^ p� rq,
16-5-38799 (14) 16-5-38799 (15)