OP RHTE# 11-546$ X52
PERMIT # 2tyS.55
Harnett County Department of Public Health 24628
Operation Per
lew Installation Septic Tank 0 Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: u s qv 1 ry .
Name: (owner) TUn.¢a L Mruxa.x^ SUBDIVISION -i-eaou {LOT # GA
System Installer: 25 as c>E, W, Registration # t/&t6
Basement with plumbing: ❑ Garage ❑ yP�ber of Bedrooms _
Type of Water Supply: ❑ Community LYPublic ❑ Well Distance from well feet
System Type: Z-5 iv a n < r .aJ� 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
rcRnu t.vnumuru:
I. Performance:
ll. Monitoring:
III. Maintenance:
IV, Operation:
V. Other.
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 -Box ❑ Pump ❑
J
H20Line ❑
Following are the specifications for the sewage disposal system on the above captioned roperty.
Type of system: ❑ Conventional D er — 1571= Jn s c, Septic Tank: /0J6 gallons Pump Tank:
Subsurface No. of exact length width of depth of
Drainage Field ditches_ of each ditch tan feet ditches -- feet ditches
French Drain Required: Linear feet
Authorized State Agent Date 0 (0 DLO 1�
Line
gallons
inches
PtSMC' '( D
qs—l;nA0-
V'LSPA12 Anc;A
ll
0
j
j
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lie
I 1455
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r
I
Yo/ .
rcRnu t.vnumuru:
I. Performance:
ll. Monitoring:
III. Maintenance:
IV, Operation:
V. Other.
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 -Box ❑ Pump ❑
J
H20Line ❑
Following are the specifications for the sewage disposal system on the above captioned roperty.
Type of system: ❑ Conventional D er — 1571= Jn s c, Septic Tank: /0J6 gallons Pump Tank:
Subsurface No. of exact length width of depth of
Drainage Field ditches_ of each ditch tan feet ditches -- feet ditches
French Drain Required: Linear feet
Authorized State Agent Date 0 (0 DLO 1�
Line
gallons
inches
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