OPHTE# ITS '4O&7y
PERMIT # I TF
Mame: (owner)
System Installer.
Basement with plumbing: ❑ Garage
Ifype of Water Supply: ❑ Community
t ystem Type:� i ) t$° ��� u
(In accordance with Table V a�o r Y
TMt�//yy��/ #. 1
ysstem has been installed in compliance with a
PERMIT CONDITIONS:
I. Performance:
ll. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
lib
I'
Harnett County Department of Public Health 24492
Operation Per it /
ew Installation 13KSeptic Tank YNitrification Line ❑ Repair ❑ Expansion
P ERTY LOCATION: /1 c/
SU VISION � � LOT # L
Reg ration #
10 Number of Be rooms I_
❑ Public Y Well Distance from
Owner
North Carolina General Statutes. Rules for
t' feet
V and VI Systems expire in S years.
Department 6 months prior to expiration for permit renewal.
and all
Permit and construction Authorization.
System shall perform in accordance with Rule .1961.��S t-�La.1`" 14)
At 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 ❑
Alarm ❑ H2O1-ine ❑ PWR Line
Following are the
specifications for the sewage disposal
system on the above captioned property.
Type of system:
EI Conventional El Other 29rpT2eeikwfiou
Septic Tank I iD0 gallons Pump Tank: gallons
Subsurface
No. of
exact length
width of depth of
Drainage Field
ditches Z—
of each ditch ZOa> feet
ditches feet ditches Zm SKI inches
french Drain Required: linear feet
Authorized State A��/� (A9 n/ ( W Date
17-5-40674 (1)
17-540674 (6)
17-5-40674 (11)
17-5-40674 (16)
17-5-40674 (2)
,/
17-540674 (7)
17-5-40674 (3)
17-540674 (6)
17-5-40674 (4)
y
17-540674 (5)
17-540674 (9)
17-5-40674 (10)
17-5-40674 (12) 17-5-40674 (13)
17.540674 (14)
17-5-40674 (15)