OPHTE# i 6 Z Harnett County Department of Public Health 24260
PERMIT #
/Operation Per It /
d New Installation Septic Tank d Nitrificalthop Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: V )36 knh `�
Name: (owner) 2ti SUBDIVISION LOT #
System Installer: r" Registration #
Basement with plumbing: ❑ Garage C;r' Number of Be"6S 3
Type of Wat�ply: ❑ Community lblic Y Well Distance from well 1 r feet
System Time: I v -2S�(L..>L {-- g Types V and VI Systems expire in S years.
(in accordance with Ta le V a) ner must contact Health Department 6 months prior to expiration for permit renewal.
QJ r�
has been installed in compliance with applicable North Carolina General Statutes. Rules for Sewage Treatment and Disoosal. and all
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
Other:
0
0
System shall perform in accordance wklf Rule .If�l. t)
As required by Rule .1961. IV��
As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
Authorization.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sewa disposal miens on the a ve captioned property.
Type of system: ❑ Conventional Other _�� Septic Tank: f U a !J gallons Pump Tank: c�0y gallons
Subsurface No. ofexact lengti width of depth of
Drainage Field ditches 3 of each ditch 100 feet ditches 3 feet ditches ches
French Drain Required: Linear feet
Authorized State In���jis a .—, l _ ��y� i�z` "'Date I I — Z7— ` ( (o
16-5-38392 (1)
'i
16-5-38392 (6)
16-5-38392 (11)
r \
16-5-38392 (2)
16-5-38392 (7)
16-5-38392 (12)
16-5-38392(3)
16-5-38392 (4) 16-5-38392 (5)
16-5-38392 (8)
16-5-38392 (13)
16-5-38392 (16)
16-5-38392 (21)
16-5-38392 (17)
;w
16-5-38392 (22)
16-5-38392 (18)
16-5-38392 (9) 16-5-38392 (10)
16-5-38392 (14)
16-5-38392 (15)
71
16-5-38392 (19) 16-5-38392 (20)