OP RHTE# -S'-3Ag-2D Harnett County Department of Public Health 24223
PERMIT # 22;6 /O /Operation Permit
New Installation Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATIO
Name: (owner) SUBDIVISION LOT #
System Installer v i _ Registration #
Basement with plumbing: ❑ Garage/y,��mber of Bedro s 3
Type of Water ply: ❑ Community L Pubfc ❑ Well Distance from well feet
System Type: �� EU Z6`Z ( r'� � s L� Types V and VI Systems expire in S years.
(In accordance with tble V a) Owner r ml� Health Department 6 months prior to expiration for permit renewal.
This system has been installed in mmoliance wills applicable North Carolina General Statutex Rules for Sewaee Treatment and disposal, and all conditions of the Improvement Permit and Construction Authorization.
PERMIT CONDITIONS:
I. Performance:
It. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
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PERMIT
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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 ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal system ton0 thea ca do property.
El of system: Conventional Other ri`N Q�/4j Septic Tank: 1620 b gallons Pump Tank: gallons
Subsurface No. of y I 1 exact length Q0 width of depth of
Drainage Field ditches 1 of each ditch V feet ditches 3 feet ditches Z q inches
French Drain Required: Linear feet
Authorized State Ag Date
16-5-38970 (1)
16-5-38970 (3)
16-5-38970 (4)
16-5-38970 (5)
16-5-38970 (6)
16-5-38970 (7)
16-5-38970 (8)
16-5-38970 (9)
16-5-38970 (10)
16-5-38970 (11) 16-5-38970 (12)
4 -}r
16-5-38970 (16)
16-5-38970 (13)
16-5-38970 (14)
16-538970 (15)