OPHTE#�b'5-3�6�-72 Harnett bounty Department of Public Health 24302
PERMIT #� 11 Operation Permit
New Installation X Septic Tank Nitrification Line F-1Repair
PROPERTY LOCATION: '»�oa950N ti
Name: (owner) �Joy<HCp.S�C�L.t G6ty. Coo. SUBDIVISION LOT
System Installer: H 9%LQox1 S Ep`i N G Registration #
Basement with plumbing: ❑ Garage '1K Number of Bedrooms a
Type of Water Supply: ❑ Communi 1 )K Public ❑ Well Distance from well feet
System Type: a Types V and VI Systems expire in S years.
(In accordance with Table V a) Owner most contact Health Department 6 months prior to expiration for permit renewal.
❑ Expansion
This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorisation
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PERMIT CONDITIONS:
I. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ N
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
❑ —D -Box ClPump ElAlarm ❑ H20Line ❑ PWR Line
Following are the specifications for the sewage disposal s stem on the above captioned property.
Type of system: ❑ Conventional Other tfy c:� Septic Tank gallons Pump Tank gallons
Subsurface of exact length width of depth of
Drainage Field ditches of each ditch S feet ditches 3 feet ditches Ie' inches
French Drain Required: �� 'ear feet
Authorized State Agent � Date I T