OPHTE#_I & -5-3153) Harnett County Department of Public Health 24335
PERMIT # Z106 z Operation Permit
Eg,levv Installation Com is Tank nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: e (-, ue s to -, 2 d (5 R! 416 '3)
Name: (owner) S L 5 /-1oivi t,5 SUBDIVISION f- cKe,66 r P -,r -K LOT # 60,,7
System Installer: A &aocK, f cu,✓<<'on Registration #
Basement with plumbing: ❑ Garagetuber of Bedrooms _
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: Z% ge� c4 of) Z'p- A'1a :tiTypes V and VI Systems expire in 5 years.
(In accordance with Table V a) =49Owner must contact Health Department 6 months prior to expiration for permit renewal.
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 Comtmaion Authorization
YtNMII LONUMUN):
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
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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 on the above captioned property.
Type of system:
❑ Conventional
111/6er Ar -c elia , r d
Septic Tank: /,060
gallons Pump Tank: gallons
Subsurface
No. of
exact length
width of
depth of
Drainage Field
ditches
.3 of each ditch �' (1_ feet
ditches �L
feet ditches 'inches
French Drain Required:
Linear feet
Authorized State
r— -
Date
16-5-39531 (1)
16-5-39531 (2)
16-5-39531 (3)
16-5-39531 (4)
16-5-39531 (5)
16-5-39531 (6)
16-5-39531(7)
16-5-39531 (8)
16-5-39531 (11) 16-5-39531 (12) 16-5-39531 (13)
16-5-39531 (9)
16-5-39531 (10)