OP RHTE# IL -9--393 5e Harnett County Department of Public Health 24354
PERMIT # 29 ods' /Operation
0 eration Permit /
New Installation 9 Septic Tank d Nitrification Line ❑ Repair ❑ Expansion
_ PROPERTY LOCATION: 4t t. X C) I
Name: (owner) 6 nil SUBDIVISION LOT #
System Installer: a. Registration #
Basement with plumbing: ❑ Garage 5 umber of Bedrooms
Type of Water Supply: ❑ Community a Public L) Well Distance from well feet
System Type: CM -0 siPiJ'Tt zsU 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.
This system has been installed in compliance with anDlinble Nonh Carolina General Statutes. Rules for Sewage Treatment and Duvosal, and all conditions
PERMIT CONDITIONS:
I. Performance:
IL Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
Z�Y
Ll
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 ❑
Following are the spe ' tions for the sewage disposal system on the above captioned property.
Type of system: Z Conventional ❑ Other
Subsurface No. of exact length
Drainage Field ditches of each ditch 8a feet
Alarm ❑
- OUT—
� � To
t 01�
H2O1-ine ❑
PWR Line
Septic Tank gallons Pump Tank: gallons
width of depth of
ditches feet ditches 24 -M % inches
French Drain Required: Linear feet
a �' /W I��,t 4� IT�+5
Authorized State entDate
16-5-38333R (1) 16-5-38333R (2) 16-5-38333R (3) 16-5-38333R (4) 16-5-38333R (5)
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16-5-38333R (6) 16-5-38333R (7) 16-5-38333R (8) 16-5-38333R (9) 16-5-38333R (10)
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16-5-38333R (11) 16-5-38333R (12) 16-5-38333R(13) 16-5.383338 (14) 16-5-38333R (15)
16-5-38333R (16) 16-5-38333R (17) 16-5-38333R (18)