OP RHTE# I1-5-41 zUjrn Harnett County Department of Public Health 24413
PERMIT # 7-9493 Operation Permi E;-Nitrification�
Elr Iew Installation Septic Tank Line Repair ❑ Expansion
G���E�n �� aF S rTorI PROPERTY LOCATION: 10 36 cte CSrs,. Is161
Name: (owner) Sham. 4- IC-5c:tca. PtQjvs SUBDIVISION LOT #
System Installer. '.mac 2c T l Registration #
Basement with plumbing: Garage ❑ Number of Bedroom
Type of Water Supply: ❑ Community ❑ Public ell Distance from well JOJ 4 feet
System Type: ZSio a c c�.+c�'v t� 1�G Types V and VI Systems expire in 5 years.
(In accordance with Table V a) J Owner must contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Was General Statutes. Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
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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 ❑ No
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
❑ D -Box ❑ Pump ❑ Alarm ❑
H2O1-ine ❑
Following are the specifications for the sewage disposal system on the above captioned kroperly.
Type of system:
El FI her /�Z Fly ...1.i�.T.—� Septic Tank: 1000 gallons Pump Tank:
Subsurface No. of exact length width of depth of
Drainage Field ditches 3 of each ditch I OCS feet ditches 3 feet ditches I
French Drain Required: Linear feet
Authorized State Agent Date c� -1-� 0 q I Zo /.-
PWR Line
gallons
inches
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