OPHTE# %6'S -amass Harnett County Department of Public Health 24579
PERMIT # a) f37. Operation Permit
New Installation )St Septic Tank 'b� Nitrification Line ❑ Repair ❑ Expansior
PROPERTY LOCATION: ii: J\3 m -i
Name: (owner) W6z tco S cj;�Cja=l , SUBDIVISION N oobn L o,c LOT #'13
System Installer: 1 so b CLV.y `1 Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms —L -
Type of Water Supply: ❑ communis Public ❑ Well Distance from well feet
System Type: x x.l 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.
I his system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and construction Authorization.
S05
1 P
2 N 1
R
4
C�rPa,Ecs oa,�E
PERMIT CONDITIONS:
I. Performance: System shall perform in accordance with Rule .1961.
II. 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.
❑
D -Box
❑ Pump ❑ Alarm ❑
H10Line ❑ PWR Line
Following are the
specifications for
the sewage disposal system on he above�ptioned property
Type of system:
Subsurface
❑ Conventional
No.
J Other Pu vl% f 0 4"cn p�-t,_ ls' eptic Tank: I DO o
gallons Pump Tank: 1000 gallons
Drainage Field
g
of
ditches
exact length width of
I of each ditch 3Q6 feet ABrhe< 3
depth of
French Drain Required: Linear feet .... "' Y111.0a aI mcnes
Authorized State Agent) 5 Date C 7 t
Bpi