OPHTE#
PERMIT #
Harnett County Department of Public Health
/0 eration Per It /
24235
❑ H2OLine
r�' New Installation Septic
Tank E /Nitrification Line
❑ Repair ❑ Expansion
PROPERTY LOCATIONzi -%' zulrtieZ6
Name: (owner) )Cj;n"ayrx,S t SUBDIVISION LOT #
System Installer. �A-rc 1310 Registration #
Basement with plumbing: ❑ Garage tuber of Bedrooms
Type of Wa Supply: ❑Community Public ❑ Well Distance from well feet
System Type: ?S'% � �a. � Types V and VI Systems expire in S years.
(In accordance with Tae V a) �,"-- :ct Health Department 6 months prior to expiration I permit renewal.
This system has been installed in compliance with applicable North Carolina General Statutes, Rules for SewageTreatmentand Disposal, and all conditions of the Improvement Per it and Construction Authorization.
I. Performance:
II. Monitoring:
Ill. Maintenance:
IV. Operation:
V. Other.
Z54
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
Type of system:
specifications for
❑ Conventional
the sewa dispos tem on the above ca In try.
[Othey U !k A %S !1 /11.5/
Septic Tank: �rcro gallons
Pump Tank: gallons
Subsurface
Drainage Field
No. of
ditches
p elect length
d of each ditch �Zy feet
width of
ditches �� feet
depth of ra
ditches 2V inches
French Drain Reouired:
Linear feet
Authorized State f%� Date It — f -7
Via MOM
Uk
16-5-38183 (1) 16-5-38183 (2) 16-5-38183 (3) 16-5-38183 (4) 16-5-38183 (5)
1 j+_
.in .
4 a y
4
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16-5-38183 (6) 16-5-38183 (7) 16-5-38183 (8) 16-5-38183 (9) 16-5-38183 (10)
16-5-38183(11) 16-5-38183(12) 16-5-38183(13) 16-5-38183(14) 16-5-38183(15)
VY
&NiNi.
16-5-38183(16) 16-5-38183(17) 16-5-38183(18) 16-5-38183(19) 16-5-38183(20)
w
16-5-38183(21) 16-5-38183(22) 16-5-38183(23) 16-5-38183 (24) 16-5-38183(25)
16-5-38183(26) 16-5-38183(27) 16-5-38183(28) 16-5-38183(29)