OPHTE# 14 -5-'6(61 Harnett County Department of Public Health
24414
PERMIT # zed 34$ Operation Permi j
New Installation Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: C.o14e,btt P�rIC Ln/LoYkSb RecA s2 tsLd3
Name: (owner) TLS 1Acjmc:f SUBDIVISION C-aKu?b'i.r, <'�s� v LOT # by
System Installer: Aco441a, d Sons 1 t.�:cw< br +��,� Registration #
Basement with plumbing: ❑ Garage � �Nyu�ber of Bedrooms
Type of Water Supply: ❑ Community I Public ❑ Well Distance from well feet
System Type: 25 %a (Z''c') -c-Tr U sJ -:a , 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.
This system has been imtxlled in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
PERMIT CONDITIONS
I. Performance:
11. 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 9-01
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
❑ D -Boz ❑ Pump ❑ Alarm ❑ N20Line ❑ PWR Line
Following are the specifications for the sewage di posal system on the above captioned property.
Type of system: ❑ Conventional Cher E� Flcaa IT^, Septic Tank: 1OOC-;' gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches I of each ditch 7100 feet ditches 3 feet ditches 7-4 inches
French Drain Required: Linear feet
Authorized State Date 0 6 /v S /