OP RRRHTE# fL-s-39353 Petz Harnett County Department of Public Health
24216
PERMIT # Operation Permit �"
tl� New Installationc Tank M Nitrification Line ❑ Repair ❑ Expansion
,.�,J/- PROPERTY LOCATION:
Name: (owner) a` ��ey SUBDIVISION LOT #
System Installer. / L���ifr r� Registration #
Basement with plumbing: ❑ Garage ❑ umber of Bedrooms ._3
Type of Water Su ply: ❑ Community f Public ❑ Well Distance from well feet
System Type: �A_— Types V and VI Systems expire in S years.
(In accordance with Tae V a) Ownercgsgact Health Department 6 months prior to expiration for permit renewal.
iJ®7.ine
This system has been installed in
1v �
�ti I I�-.111r
t
I. Performance:
II. Monitoring:
111. Maintenance:
IV. Operation:
V. Other.
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.
Permit and Construction Authorization.
❑
D -Box ❑
Pump ❑
Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewgg6 disposal system on the above ca tion," property.
Z.Sya kAD0 L
Type of system: ❑
Conventional C� Other
Septic Tank 40040 gallons Pump Tank: /du d gallons
Subsurface
Drainage Field
No. of
ditches
exact length
of each ditch Z�G` feet
width of depth of
ditches 3 feet ditches inches
French Drain Retained:
Linear feet
Authorized State 7s°"t , Date 11-1—'(6
16-5-38353RRR (1)
16-5-38353RRR (2)
16-5-38353RRR (6)
16-5-38353RRR (7)
16-5-38353RRR (11)
16-5-38353RRR (12)
16-5-38353RRR (16)
16-5-38353RRR (17)
- � n
16-5-38353RRR (21) 16-5-38353RRR (22)
16-5-38353RRR (3)
16-5-38353RRR (8)
r 16-5-38353RRR (13)
i
16-5-38353RRR (18) J
16-5-38353RRR (4) 16-5-38353RRR (5)
16-5-38353RRR (9) 16-5-38353RRR (10)
16-5-38353RRR (14) 16-5-38353RRR (15)
16-5-38353RRR (19) 16-5-38353RRR (20)