OPHTE# ►(e s y�(`�5 Harnett County Department of Public Health 24652
PERMIT# beration Permi
L New Installation eptic Tank J' Nitrification Line ❑ Repair ❑ Expansion
�/ PROPERTY LOCATION: 6 r,;r2 SC. 6(wji'6g &4. 52 )yz9L_
Name: (owner) WInc� Ccn<ir X l'rC)n Lnc. SUBDIVISION � , sGA CAr>C LOT # 26
System Installer. 4,oh ' 6ublic
S,,�r Registration # Lj
Basement with plumbing: ❑ Garage o Bedrooms
Type of Water Supply: ❑ Community ❑ Well Dice from well feet
System Type: fLe.c�a tC, 5 S, Li Types V and VI Systems expire in S years.
(In accordance with Table V a) wner must contact Health Department 6 months prior to expiration for permit renewal.
Ims system has been installed in compliana with appliable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and construction Authorization.
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150"t ncvaL-'V.
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ii CP 1St
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1304C
500 I(W 5 .
PERMIT CONDITIONS:
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 Pf
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
❑ D -Box ❑ Pump ❑ Alarm ❑
H2OLine ❑
Following are the
specifications for
the sewage disposal system on the above ca 'er property.
Type of system:
❑ Conventional
f�t her ri . /o_ a
Septic Tank: I ZC0 gallons Pump Tank-
ankSubsurface
Subsurface
Drainage field
No. of
ditches
exact length
5 of each ditch 160 feet
width of depth of
ditches2�
feet ditches
trench Drain Required: Linear feet
Authorized State Agent ��� Date
PWR Line
gallons
inches
A :a
1- i F ak''.y •
W
86'9;....-�.
In
V)