OPHTE# /lr 'S -Y 68 Harnett County Department of Public Health 24270
PERMIT # Z8099 Operation Permit
Li" New Installation UK Septic Tank 2 Nitrification Line ❑ Repair ❑ Expansior
PROPERTY LKATIO./ cxea v .0
C
Name: (owner) A).) Cis T�+c SUBDIVISION ¢✓ LOT #
System Installer: Registration #
Basement with plumbing: ❑ Garage 2 /Number of Bedrooms je
Type of Water Sup ly: ❑ Commune�j Lel P blit ❑ Well Distance from well feet
System Type: Types V and VI Systems expire in S years.
(In accordance with Table V a) `-� Ownerewontact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with aooliable North Carolina General Statutes, Rules for Sewa0matment and Disposal, and all conditions of the Imnroyement Permit and construction Authorization.
PERMIT CONDITIONS:
1. 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 ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑
Following are the specifications for the seewwaa disposal system on the above ccphonedd proserty.
Type of system: ❑ Conventional lei Other Z1;z VLOr.IG� 4 Septic Tank: /Lon gallons Pump Tank:
Subsurface No. of exact length / width of Z depth of Z,--,Pb
Drainage Field ditches of each ditch � feet ditches 3 feet ditches
'Q S
French Drain Required: Linear feet
Authorized State A¢ IeL�— t �/ Date I ) - 2I —
_ PWR Line
gallons
inches
16-5-38968 (1)
•x
16-5-38968 (6)
16-5-38968 (2)
16-5-38968 (7)
16-5-38968 (3) 16-5-38968 (4)
16-5-38968 (5)
16-5-38968 (8) 16-5-38968 (9)
16-5-38968 (11)
16-5-38968 (16)
16-5-38968 (12)
16-5-38968 (13) 16-5-38968 (14)
16-5-38968 (10)
16-5-38968 (15)