OPHTE# 16-5 - 3yc� 8 Harnett County Department of Public Health 24336
PERMIT # 2 8985 Operation Per It
Q" New Installation Septic Tank CO' Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:_G�
Name: (owner)(n)4r\ Cc,"5}f"c_S,:oI) SUBDIVISION Aver, Pond LOT # 3/
System Installer. 7 t Registration #
Basement with plumbing: EJ Garage � umber of Bedrom_
Type of Water Supply: ❑ Community ld Public ❑ Well Distance from well feet
System Type: %-.5"iG(J[cxocX"'o 5 295; �
641r,,,s E G/. Types V and VI Systems expire in S years.
(In accordance with Table V a) Owner 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 Construction Authorization
/LS'io CLacoQC Tlo J
QL,'U0.t2 AR.vyA—
:45t C 4)
to, 25 jn . 4. as I
lig
Lk !L
1S �IS7
3 '
PERMIT CONDITIONS:
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
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 ❑ 1-1201-ine
❑ PWR Line
Following are the
specifications for
the sewage disposal system on the above captioned property.
Type of system:
❑ Conventional
L3� Other /z J — A, o �,../< •
Septic Tank: gallons
Pump Tank: gallons
Subsurface
No. of
exact length
width of
depth of
Drainage Field
ditches
4- of each ditch feet
ditches _� feet
ditches Z Z inches
French Drain Required:
linear feet
Authorized State Ageni1, �� Date —
16-5-39008 (1) 16-5-39008 (2) 16-5-39008 (3) 16-5-39008 (4) 16-5-39008 (5)
r -
a
16-5-39008 (6) 16-5(39008 (7) 16-5-39008 (8) 16-5-39008 (9) 16-5-39008 (10)
sl
16-5-39008 (11) 16-5-39008 (12) 16-5-39008 (13) 16-5-39008 (14) 16-5-39008 (15)
16-5-39008(16) 16-5-39008(17) 16-5-39008(18) 16-5-39008(19) 16-5-39008(20)
'w
16-5-39008 (21)