OP RHTE# )(cj! 5_-ZMSON U Harnett County Department of Public Health 0 A
PERMIT Operation Permit 4 0 7
New Installation Septic Tank" Nitrification Line ❑ Repair El Expansion
PROPERTY LOCATION: f1ocax5
Name: (owner) C_i7gyra„4 VASar C-> SUBDIVISION LOT #
System Installer. 9—r"5 5ee5,F_ S1341vNCX_ Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms tmj-
Type of Water Supply: ❑ Community lk� Public ❑ Well Distance from well 100 feet
System Type: �;; 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.
cors system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and construction Authorization.
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PERMIT CONDITIONS:
I. Performance:
II. Monitoring:
Ill. 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 to
maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal system on the ab/ov�e ca eed property.
Type of system: ❑ Conventional )< Other GAP+cagG2 W7�./ Septic Tank: 1000 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field dl of each ditch a7 0 feet ditches .3 feet ditches inches
French Drain Required: Linear feet
Authorized State Agent_ \1! \\�\\� Q4.:y7 Date