OP RHTE# (c�-�-3$szslz Harnett County Department of Public Health 24332
PERMIT # 2-13 Operation Permit
New 'Installation
c Tank IK Nitrification Line ❑ Repair ❑ Expansion
/--� -- ���� LI -61
LOCATION: 0-f2 2n� 1415��/�4>J
Name: (owner) l� iZ�, ,/�61 BDIVISION��� k . ✓ ir,v �,.r,,r�s LOT #
System Installer: —i�z TRegistration #
Basement with plumbing: El Garage Number of Bedrooms -
Type of Water Supply: ❑ Community EJ� Public ❑ Well Distance from well feet
System Type: 2s"se, IiLft20 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.
has been installed in ampliance with applicable North Carolina General Statutes,
I. Performance:
Il. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
,z.
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.
N/�)s ?t,�
❑ D -Box Cl Pump ❑ Alarm ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sewaaaje disposal system on the above captioned property.
Type of system: ❑ Conventional Lx Other ZS%I&X Septic Tank gallons Pump Tank ivy J gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch Z`(0 feet ditches 3 feet ditches inches
French Drain Required: Linear feet
Authorized State
Date 01 ► Z
16-5-38529R (1) 16-5-38529R (2) 16-5-38529R (3) 16-5-38529R (4) 16-5-38529R (5)
7.
w4
16-5-38529R(6) 16-5-38529R (7) 16-5-38529R (8) 16-5-38529R(9) 16-5-38529R (10)
NOW
16-5-38529R (13) 16-5-38529R (14) 16-5-38529R (15)
16-5-38529R (16) 16-5-38529R (17) 16-5-38529R (18) 16-5-38529R (19) 16-5-38529R (20)
16-5-38529R (21) 16-5-38529R (22) 16-5-38529R (23) 16-5-38529R (24) 16-5-38529R (25)
T
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Y. h
16-5-38529R (26) 16-5-38529R (27) 16-5-38529R (28)