OPHTE#OG�S'I`tSa% Harnett County Department of Public Health 24247
PERMIT # 28 /Operation Permit
New Installation Septic Tank i Nitrification Line Repair ❑ Expansion
PROPERTY LOCATION=;&r7v5 din sCfaOC✓� /0
Name: (owner) �� dbGS SUBDIVISION li LOT #
System Installer: CT"27 s J4VnXC4&1W—ems Registration #
Basement with plumbing: ❑ Garage tuber of Bedrooms 3
Type of Water Supply: 0Community Public ❑ fell l .Distance from well feet
System Type: _ 2SSA V and VI Systems expire in S years.
(In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
This setters has been
PERMIT CONDITIONS:
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
North Carolina G(neral Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
yj
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 ❑ — Alarm ❑
Following are the specifications for the sews Isposal system on the above captioned property.
Type of system: ❑ Conventional IT Other
Subsurface No. of �{ exact length
Drainage Field ditches 1 of each ditch �7 V feet
French Drain Required: Linear feet
H2OLine ❑
PWR Line
Septic Tank: _ gallons Pump Tank: I V gallons
width of depth of
ditches 3 feet ditches inches
Authorized Sta gent �—� Date /b -3 / --/ (P
)2 Richard Dickens Repair 10- )2 Richard Dickens Repair 10. )2 Richard Dickens Repair 10. )2 Richard Dickens Repair 10- )2 Richard Dickens Repair 10.
Lk
)2 Richard Dickens Repair 10- )2 Richard Dickens Repair 10. )2 Richard Dickens Repair 10- )2 Richard Dickens Repair 10. 2 Richard Dickens Repair 10-:
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2 Richard Dickens Repair 10-: 2 Richard Dickens Repair 10-: 2 Richard Dickens Repair 10: 2 Richard Dickens Repair 10-: 2 Richard Dickens Repair 10-:
i `
_iii.:
2 Richard Dickens Repair 10-: 2 Richard Dickens Repair 10-: 2 Richard Dickens Repair 10-: 2 Richard Dickens Repair 10-: 2 Richard Dickens Repair 10-: