OPHTE# I G—`5'3Ci0ioa Harnett County Department of Public Health 24601
PERMIT # 0,—t �D� Operation Permit
XNew Installation �'K Septic Tank X Nitrification line ❑ Repair ❑ Expansion
PROPERTY LOCATION: US"i N
Name: (owner) =orctJ SUBDIVISION-T;wNPC1,ActiSPayL DC -L JOT # f
System Installer. -TO vgA04- Registration #
Basement with plumbing: ❑ Garage %Z Number of Bedrooms H
Type of Water Supply: ❑ Community �. Public ❑ Well Distance from well feet
System Type: '-i]D Types V and VI Systems expire in S years.
(In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Camlina General Statutex Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and tonmmUn Aumomahon.
Ad , ATotwe
I
r i
7 6'
O \laO%f
D
2
4
PERMIT CONDITIONS
I. Performance: System shall perform in accordance with Rule .1961.
II. Monitoring: As required by Rule .1961.
III. Maitjenance: 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 ❑
H2OLine ❑ PWR Line
Following are the specifications for
the sewage dispossystem on the above captioned properly.
Type of system: 11
Conventional
Other
y enE'� E7—FesZr Septic Tank: to 6 0
gallons Pump Tank: 10,00 gallons
Subsurface
No. of
exact length width of
depth of
Drainage Field
ditches
3
of each ditch 1 O G feet ditches ...3
feet ditches \�a inches
French Drain Reeuirer�r�
��
Linear feet
Date
Authorized State Aeent �� W N> 1