OPHTE# &-S'— 32dQ Harnett County Department of Public Health 24474
PERMIT # z8!1! / Operation Permit /
d New Installation Septic Tank L/ Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION.0 q1g,/?a�tlZb
Name: (owner) �n rLs 9_�C3 All SUBDIVISION LOT #
System Installer: ��ia�e` ry(A Registration #
Basement with plumbing: ❑ Garageumber of Bedrooms �—
Type of Water Supply: ElCommuni �ublic ❑ Well Distance from well feet
System Type: a (L kos„c P� .,j <-'s 4ta— tsr --, G7 LAe ypes V and VI Systems expire in S years.
(In accordance with Table V a) Owner must contad Health Department 6 months prior to expiration for permit renewal.
has been installed in compliance with appliable North �rolina General statutes, Rules for Sewage Treatment and Disposal, and all conditions If the Improvement Permit and commission Authorization.
PERMIT CONDITIONS
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
N1�3
'9 Id /VA
1
V
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 -Boz ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewa disposal system on the above captioned property.
Type of system:
El Other Z!NM DGn(i (f( I Septic Tank: I Zoe) gallons Pump Tank: gallons
Subsurface No. ofenact length Q width of depth of
Drainage Field ditches 7` of each ditch SO feet ditches feet ditches _L� inches
French Drain Required: Linear feet
Authorized State Ageai �/h,/ � Date N — I'L
16-5-39085(1) 16-5-39085 (2) 16-5-39085 (3) 16-5-39085 (4) 16-5-39085 (5)
16-5-39085 (6)