OPHTE# 110- 5--3gW Harnett County Department of Public Health 24339
PERMIT # 7-F>5 96-7 . Operation Permit
C� New Installation O Septic Tank 2 Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: �u SS
Name: (owner) SGO �L J7' L SUBDIVISION N: ry moi/ �/1Pe1r LOT #
System Installer: _ <! Registration #
Basement with plumbing: ElGarage Number ofBe ooms 3
Type of Water Supply: ❑ Community O Public `Well Distance from well 160' feet
System Type: 2 - - -ta- - -Types-.µ-and_VlSysXrns ex ire in Sears.
(In accordance with Table V a) i Owner must CW7Health Department 6 months prior to expi tion for permit renewal.
YtNNII LUNUIIIUNS:
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 ❑ F120Line
❑ PWR Line
Following are the
specifications for
the sewq�e disposal system on the above captioned property.
Type of system:
❑ Conventional
C7� Other25 ��o /Z&i)y
Septic Tank: gallons
Pump Tank: gallons
Subsurface
No. of
? exact length
width of
depth of
Drainage Field
ditches
.J of each ditch /6( feet
ditches feet
ditches ZG inches
French Drain Required: Linear feet
Authorized State Aent Date y - / S —/ 7
--- l
16-5-39291 (1) 16-5-39291 (2) 16-5-39291 (3) 16-5-39291 (4) 16-5-39291 (5)
M.e_y
16-5-39291 (6) 16-5-39291(7) 16-5-39291(8) 16-5-39291(9) 16-5-39291(10)
t
16-5-39291 (11) 16-5-39291(12) 16-5-39291(13) 16-5-39291(14) 16-5-39291(15)
.. a. -
16-5-39291(16) 16-5-39291(17) 16-5-39291(18) 16-5-39291(19)