OPHTE# 17-54 Harnett County Department of Public Health 24589
PERMIT # ���J`c Operation Permit
New Installation '�< Septic Tank )<nNitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: �rt tt�as s7ie
Name: (owner) V-a`h*L()avcS t>L$:s.\N 6 GtR SUBDIVISION LOT # Ll�
System Installer: E , ,,-s r"6o i.l rd Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms 4
Type of Water Supply: ❑ Community %K Public ❑ Well Distance from well feet
System Type:'o. Types V and VI Systems expire in S years.
(In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
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FERMII CUNDIIIUNS:
I. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring: As required by Rule .1961.
111. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes El No-k,�
If yes, see attached sheet for additional operation a
IV. Operation:
V. Other.
Ale kt'.PCO we�1i
maintenance and reporting.
❑
D -Boz
❑ Pump ❑ Alarm ❑
H20Line ❑
Following are the
specifications for
the sewage disposal systema the above captioned property.
Type of system:
ElConventional
Other E. -?-Y i.O W Septic Tank: 100 0
gallons Pump Tank:
Subsurface
. of
exact length width of
depth of
Drainage Field
ditches
of each ditch 3 feet ditches 3
feet ditches _
French Drain Re
Linear feet
Authorized State hent T106+V Date
PWR Line
gallons
1$ a1 inches
m