OP RHTE # L --S— I �c7 r• Harnett County Department of Public Health 24343
PERMIT # V3/Operatfion Perak
New Installation Septic Tank Nitrification Line ❑ Repair ❑ Expansion
/� PROPERTY LOCATION 2t S' J,a.e ,e�Cn.#L, /�
�- r
Name: (owner) cU✓.l �� SUBDIVISION /r32s� lie /►t LOT #
System Installer. Registration #
Basement with plumbing: ❑ Garage tuber of Bedrooms 3
Type of Water Supply: ❑ Comm Public ❑ Well Distance from well feet
System Type: _ S16 �' �aiT 5 h�y� ee V and VI Systems expire in S years.
(In accordance with Table V a) Owner must tMea*Department 6 months prior to expiration for permit renewal.
ms system has been installed lin compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and ConsPucton Authorization
n
s
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PERMIT fnMnITIaMt•
I. Performance:
If. 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 ❑ H2OLine
❑ PWR Line
Following are the specifications
for the
sewa sposal Ystem on the above captioned property.
Type of system: El
Conventional
Other ZS X00 &711641"
Septic Tank: gallons
Pump Tank: gallons
Subsurface
No. of
exact length
width of
depth of as
Drainage Field
ditches
of each ditch } oto feet
ditches d feet
ditches Zy inches
French Drain Required:
Linear feet
Authorized State AoL�--
Date
<% LAy
1 1 1 1 1
r
. L-ev-.77-
07-5-18941R (6) 07-5-18941R (7) 07-5-18941R (8) 07-5-18941R (9) 07-5-18941R (10)
w. 1 IMM, 11
AM
•d) y a. J :.�^M1
07-5-18941R (11) 07-5-18941 RS(12) 07-5-18941R (13) 07-5-18941R (14) 07-5-18941R (15)
07-5-18941R (16) 07-5-18941R(17) 07-5-18941R (18) 07-5-18941R(19) 07-5-18941R (20)