OP RHTE# I� - S - 4Ot0i"L
Harnett
County Department of Public Health
24631
PERMIT # 1A 514
specifications for
Aeration Permit
Type of system:
❑ Conventional
New Installation eptic Tank 2f Nitrification Line
❑ Repair ❑ Expansion
Subsurface
No. of
PROPERTY LOCATION: L>.,sn G c t_ L L n C
--z� C- 5�
Name: (owner) lbcoca &Z&n
i01 SC-
SUBDIVISION
LOT -#
System Installer. jL56n 01"&YV'-05
Linear feet
Registration #
Basement with plumbing. ❑ Garage ❑
Number ofBeams a—
Type of Water Supply: ❑ Community ❑
Public E� Well Distance from well feet
System Type: _A T- - G.•,&< . Z 5w
A,P.6,ic 6 Fo n !$ Types V and VI Systems expire in S years.
(In accordance with Table V a)
�
�s
Owner must contact Health Department 6 months prior to expiration for permit renewal.
mis system has oven installed in comphance Mrs applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal and all conditions of the Improvement Permit and romtrueion Authorization
4-r-C"
L g _APC
t r2r
ZwZ Si `
°^',cis,
n6n
� d
� Cover
I
25i aE�, '2
IMS' (r L1 WELL
n
r[i1flr1 1AtlU11111tl):
I. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring: As required by Rule .1961.
III. 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.
❑
ID -Box
❑ Pump ❑
Alarm ❑ H2OLine ❑ _
Following are the
specifications for
the sewage disposal system on the above wptiandn�nor
Type of system:
❑ Conventional
Q—Other � ;�& �
Septic Tank: I OC, G gallons Pump Tank:
Subsurface
No. of
exact length
width of depth of
Drainage field
ditches
3 of each ditch 70 feet
ditches feet ditches
French Drain Required:
Linear feet
( I,
Authorized State Agent Ll��� /��.fls -s/ 4�f/ Date 0:4
PWR Line
gallons
(Z inches
'Z C)
k�'ll .,!Jf
;;r � r t
� .'
!, ..I/1
`Yj
ih 1 'I �(1 y .
�J ,,� ;�,
9 `,
� ti �:
i ..
.� v
L.�
J'� � �..
J"'-