OP RHTE# �forJ 3`1�O�J2 Harnett County Department of Public Health 24466
PERMIT # a�11�a— Operation Permit
XNew Installation )SK Septic Tank X Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: N"iEpo, sssu;r loufl 1;�o
Name: (owner) Mcy"6t; "iAonbs LLC SUBDIVISION LOT # I°s�
System Installer: �o� E G�62 Registration #
Basement with plumbing: ❑ Garage �K Number of Bedrooms 3
Type of Water Supply: ❑ Comm
uni ,R Public ❑ Well Distance from well 100' feet
System Type: f.\ 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.
[his system has been installed in compliance wi li applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all canditions of the Improvement Permit and Construction Authorization
PERMIT CONDITIONS
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
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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.
V. Other.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above boned property.
Type of system: ❑ Conventional Other C.. p-mgis _ (Q Septic Septic Tank: two gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage field ditches of each ditch 01.5 feet ditches 3 feet ditches I$ inches
French Drain Required: n �\ l'hwar feet
Authorized State Agent ed—A.5 Date
IQ - 5 -3c��05