OPHTE# q— 5- y (3q5 Harnett County Department of Public Health 24634
PERMIT # ' -b eration Per
RT"New Installation Septic Tankitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: EioreACp
Name: (owner) 0 I's, SUBDIVISION L T #
System Installer: L-iArrj Registration #
Basement with plumbing: ❑ GarageBedrooms_
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: ^Lal ( C 1 NQS Types V and VI Systems expire in 5 years.
(In accordance with Table Y a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in mmplianm with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improeemem Permit and Construction Authorization.
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PERMIT CONDITIONS
IV.
Performance: System shall perform in accordance with Rule .1961
Monitoring: As required by Rule .1961.
Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ No fY
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
Operation:
V. Other.
❑
D -Box ❑
Pump ❑ Alarm ❑
H2OLine ❑ PWR Line
Following are the
specifications for the seewwa isposal
system on the above captioned property.
Type of system:
El Conventional bd' Other
Septic Tank:
t gallons Pump Tank: gallons
Subsurface
No. of
exact length width of
depth of
Drainage Field
ditches 3
of each ditch feet ditches
feet ditches_ inches
trench Uram Required: Linear feet
Authorized State Agenty'�'Oate rJ��1
M
1
r+-
Central Carolina Holdings
rr
Customer: 0369650001 / Larry Sharpes
Generator: NA / Not Applicable
Dest: DEST: CUSTOMER / Customer
Truck: LARRY SHAR
Comment:
Ticket: 1235248
Date:7/7/2017
Time:13:58:20 - 13:59:03
Scale
Gross: 43200 lb Out Manual Wt
Tare: 22140 lb In Manual Wt
Net: 21060 lb
Origin Wastes & Sevices Quantity Unit Rate/Unit Amount
------------------------------------------------------------------------------------------
NA / Not Applicable DFMT116/Drain Fill Material 10.53 TON $25.00/TN $263.25
Total Taxes: $18.42
Total Amount: $281.67
Weighmaster: Driver:
Libby Cameron
This load of fire chips is from the Fuei Grade location and meets the Ne specific�lpn W
staled in Innovative Wastewater system approval IWWS-2002.03R for fire cldp
SWsslltallon for Rock A09re9rate in Nitrification Fleids.