OPNTE# I-) -JS-44 )—} G Harnett County Department of Public Health 24582
PERMIT # °`S u Operation Permit
New Installation Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: GaCADES L*J
Name: (owner) ROS:^ Pe►oA SUBDIVISION W fSw04D t -t LOT # 66 f
System Installer: L—PfVxY SN*.WE Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms
Type of Water Supply: ❑ Community Public ElWell Distance from well feet
System Type: �_ S�§ 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 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
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 El'y,`�
If yes, see attached sheet for additional operation ct
IV. Operation:
V. Other.
�x as SSA
HOWs E -
i? F
�q, l
maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: Elconventional X Other 110.E CHwPS Septic Tank: VDOy gallons Pump Tank: gallons
Subsurface No. ofexact length width of depth of
Drainage Field ditches of each ditch 150 feet ditches 3 feet ditches j(r" s inches
French Drain Require : Linear feet
Authorized State Agent EPT Date
Central Carolina Holdings
Customer: 0369650001 / Larry Sharpes
Ticket: 1223015
Date:6/19/2017
Time:15:47:26 - 16:06:10
Scale
Gross: 43340 lb Out Manual Wt
Tare: 22100 lb In Manual Wt
Net: 21240 lb
Generator:
NA / Not Applicable
Dest:
DEST: CUSTOMER / Customer
Truck:
LARRY SHAR
Comment:
Origin
Wastes & Sevices
Quantity Unit Rate/Unit
Amount
------------------------------------------------------------------------------------------
NA / Not Applicable DFMT116/Drain Fill
Material 10.62 TON $25.00/TN
$265.50
Total Taxes:
$18.58
Total Amount:
$284.08
Weighmaster:
Driver:
Libby Cameron
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This !000 ; 1i I2 r,Clps 1s frcm the I"'I r „-. i,. ro!,^r on. mc:+tt the NC 9rxN010001) (AS
S%, a oi_i 'lJuauiR un dre eh{p
Sut d�l,o,i icy kock Aggreprafe in Fu,tificmion Flows.