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of NTE# I F�-.r--3�l,7 Harnett County Department of Public Health 24251 PERMIT# L38ZI Operation Permit / New Installation Septic Tank ©/Nitrification Line ❑ Repair ❑ Expansion PROPERTY LOCATION: ac-/Yo7 �VV - is Name: (owner) %'-�Q�. �tBi s�*�� SUBDIVISION LOT # System Installer: Registration # Basement with plumbing: ❑ Garage Number of Bedrooms_ Type of Water Sup_ply:. �❑ Community ublic ❑ Well Distance from well feet System Type: 25"p-25"pT02 rlrCe Types V and A Systems expire in S years. (In accordance with Table V a) �r Uwner le Healt Department 6 months prior to expiration for permit renewal. This system has been installed in compliance with applicable North Carolina General Statutes, Rules for !S:,ttatment and 'spmal, and all condmom of the Improvement Permit and Consouction Authorization. ��7 I. Performance: System shall perform in accordance w,�t Rwl�t96.= II. Monitoring: As required by Rule .1961. aZe III. Maintenance: As required by Rule .1961. Other. �`tDtD Subsurface system operator required? Yes ❑ No ❑ If yes, see attached sheet for additional operation conditions, maintenance and reporting. IV. Operation: V. Other. ❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line Following are the specifications for the sewagR disposal system on the above captioned property. �,,�., Type of system: ❑ Conventional Q' Other 75E!72 Ii; Septic Tank �'� gallons Pump Tank gallons Subsurface Drainage Field No. of ditches 2— exact length of each ditch �rJ0 feet width of ditches 3 feet depth of ditches inches French Drain Reouired: Linear feet Authorized State Date �i— 16-5-38667 (1) 16-5-38667 (2) 16-5-38667 (3) 16-5-38667 (4) 16-5-38667(5) 16-5-38667 (6) 16-5-38667 (7) 16-5-38667 (8)