OPHTE#Ito —S 39/8 52- Harnett County Department of Public Health 24353
PERMIT # 2 U Operation Peri kt
lew Installation Septic Tank Gr Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATIONAL l c77T�
Name: (owner) S— C1C SUBDIVISION d X l=-C_h t J71r1iY5 LOT #
System Installer: nTi— Registration #
Basement with plumbing: ❑ Garage mber of Bedrooms �
Type of Water Supp : ❑ fommunity Public ❑ Well Distance from well feet
System Type: _ s V and VI Systems expire in S years.
7
(In accordance with Table V a) Owner must contac ealth Department 6 months prior to expiration for permit renewal.
mu system has been mstalled In compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal. and all conditions of the Improvement Permit and (onstmction Authorization
1. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
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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
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sew a disposal syst�n th above captioned property.
Type of system: Conventional Other S %D /� Septic Tank: gallons Pump Tank Oma gallons
Subsurface No. of exact length width of depth of g
Drainage Field ditches of each ditch �z feet ditches L— feet ditches inches
trench Drain Required: Linear feet
Authorized State A Date AS
16-5-39832 (1) 16-5-39832 (2) 16-5-39832 (3) 16-5-39832 (4) 16-5-39832 (5)
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16-5-39832 (6) 16-5-39832 (7) 16-5-39832 (8) 16-5-39832 (9) 16-5-39832 (10)
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16-5-39832 (11) 16-5-39832 (12) 16-5-39832 (13) 16-5-39832 (14) 16-5-39832 (15)
16-5-39832 (16) 16-5-39832 (17) 16-5-39832 (18) 16-5-39832 (19) 16-5-39832 (20)
,Mml�� m m m wom"�
16-5-39832(21) 16-5-39832(22) 16-5-39832(23) 16-5-39832(24) 16-5-39832(25)
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16-5-39832 (31) 16-5-39832 (32) 16-5-39832 (33) 16-5-39832 (34) 16-5-39832 (35)