OPHTE# 6 - S91ZI Harnett County Department of Public Health 24342
PERMIT # 2 0 eration Permit
Jew Installation eptic Tank 9_ if�cation Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:12aiI;nS RA 5 2 1413
Name: (owner) Qck-6�,c crV 140Wr., SUBDIVISION '%dn_ LOT # - <
System Installer. — Registration #
Basement with plumbing: ❑ GarageNr of Bedrooms 4-
V
Type of Water Supply: ❑ Community I�Public ❑ Well Distance from well feet
System Type: Types V and VI Systems expire in S years.
(In accordance with Table V a) caner 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
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I. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring: As required by Rule .1961.
111. 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 ❑ H20Line
❑ PWR Line
Following are the specifications for
the sewage sal system on the above captioned property.
Type of system: ❑
Conventional
Other ZS% (4a —4L o o f24Y_' vl�
Septic Tank: \ ZSa gallons
Pump Tank gallons
Subsurface
No. of
exact length
width of
depth of
Drainage Field
ditches
J of each ditch Chi _ feet
ditches f feet
ditches inches
French Drain Required:
linear feet
Authorized State
0
Date ) L L-17
16-5-39121 (6)
MOW
16-5-39121(7)
16-5-39121 (11)
16-5-39121 (12)
16-5-39121 (4)
16-5-39121 (8)
• �i+a-xi
•16-5-39121 (13)
16-5-39121(9)
16-5-39121 (5)
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16-5-39121 (10)
16-5-39121 (14)
16-5-39121 (15)