OPHTE# I(a—�SR Harnett County Department of Public Health
24472
PERMIT # 9D Operation Per It
Q New 'Installation c Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:s fZ Z ZI S- _.s� )2,j_
Name: (ownerVyt to NLf4./��g�442, UBDIVISION ay jm4 6 107-J LOT # I
System Installer: Zj.4scS). � Registration #
Basement with plumbing: ❑ Garage 11"umberof Bedrooms
Type of Water Supply: ❑ Community IJ' Public ❑ Well Distance from well feet
System Type: 5 ypes V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner mist contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in ampliante with applicable North Carolina General Statutes, Rules far Sewage Treatment and Disposal, and all conditions of the Improvement Permit and construction Authorization
PERMIT CONDITIONS
I. Performance:
ll. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
4o25%
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D(LD
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 disposal system on the above optioned property.
Type of system: ❑ Conventional ( Other Z'S 0),A %l�.-,1�U(�T'ZJS'ii Septic Tank: I Z Q D gallons Pump Tank gallons
Subsurface No. ofexact length width of depth of
Drainage Field ditches Z of each ditch SD feet ditches —3 feet ditches 2 Si inches
French Drain Required: Linear feet
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Authorized State Ment— G ,--- Date Z 13 — 1'�
16-5-39691 (1)
y
l 4
16-5-39661(6)
as
16-5-39650 (11)
16-5-39691(2) 16-5-3965fl (3)
16-5-396M (7)
16-5-39651(8)
16-5-39651(12)
16-5-39651(13)
'' Af
16-5-39661(4) 16-5-39691(5)
16-5-39651 (9) 16-5-3965'1 (10)
16-5-39651(14) 16-5-39651(15)
16-5-3965°1(16) 16-5-39651(17) 16-5-39651(18)
16-5-39651(19)