OPHTE# (cD-5-S11"L Harnett County Department of Public Health
24341
PERMIT # 'A a Operation Permit
New Installation peptic Tank Vitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:—(L otk, n s Zd SGL 14 L3
Name: (owner) 1r)�a �r�m�,N �ptvpS �R(„ SUBDIVISION `slna_ gasrcv� LOT # =I
System Installer: L-L4h:P. /- ��rr� Registration #
Basement with plumbing: ❑ Garage LM" umber a( Bedrooms g
Type of Water Supply: ❑ Community L;dr Public ❑ Well Distance from well feet
System Type: Z6t O Aa s. Types V and A 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 with applicable Noah Carolina General Sutures, Rules far Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
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PERMIT CONDITIONS
I. Performance: System shall perform in accordance with Rule .1961.
If. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ No
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
❑
D -Box
❑ Pump ❑
Alarm ❑ H2OLine
❑ PWR Line
Following are the
specifications for
the sews disposal system on the above captioned property.
Type of system:
El Conventional
ISS Other 95,�; an ( y
- Septic Tank:/250 gallons
Pump Tank: 1ZSQ gallons
Subsurface
No. of
C exact length
'
width of
depth of
Drainage Field
ditches
,
J of each ditch � feet
ditches_ feet
ditches Zci`— inches
French Drain Required: _
Linear feet
Authorized State
11
Date ! — 7 u
16-5-39124 (1) 16-5-39124 (2) 16-5-39124 (3) 16-5-39124 (4) 16-5-39124 (5)
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16-5-39124 (6) 16-5-39124 (7) 16-5-39124 (8) 16-5-39124 (9) 16-5-39124 (10)
16-5-39124 (11) 16-5-39124 (12) 16-5-39124 (13) 16-5-39124 (14) 16-5-39124 (15)
lit -
i
-= s
16-5-39124 (16) 16-5-39124 (17) 16-5-39124 (18) 16-5-39124 (19) 16-5-39124 (20)
NIL
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16-5-39124 (21) 16-5-39124 (22) 16-5-39124 (23) 16-5-39124 (24) 16-5-39124(25)
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e
16-5-39124 (26) 16-5-39124 (27) 16-5-39124 (28)