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OPHTE# 1 —4jq3PHarnett County Department of Public Health 2 4 2 PERMIT # Z" YYv Operation Permit ©/New Installation El&ptic Tank Vitrification Line ❑ Repair ❑ Expansion PROPERTY LOCATION: 3ay ua,rt ice. Lim i124) Name: (owner) Llsr;y(,n. r°rd•k SUBDIVISION LOT # System Installer. 1 ( SkL e Registration # Basement with plumbing: ❑ Garage ❑ Number of�Beddrr °ms Type of Water Supply: ❑ Community El Public L`7 Well Distance from well r 0U feet (Pena : n5 - r - System Type: Cyn anLir.na/ .7 o Ch;,? Sys• 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. > >pmm nu umn nnwncu ni mniY"°"te wn° aPP"taurc nurun tarunnu venerau mums, Rules nor Jewage nreaMent ana unposal, ana an conartwns of the Improvement P!!mn and tonstrucnon Authorization. F- 4 I ISI 2r?O.�tz A.rL i r i ZOC 3) d t I U 33a 1� W 'Sr n � I^ PrL opo SEY p2/ r� '. ( P2tx`JS�D wEIL ( 5R zz L<i) PERMIT I. Performance: System shall perform in accordance with Rule .1961. ll. 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 ❑ 14201-ine ❑ PWR Line Following are the specifications for the sewa e ' osal system on the above captioned property. Type of system: El Conventional Other ?f rL elk". Septic Tank: %v('70 gallons Pump Tank: gallons Subsurface No. of exact length T width of depth of Drainage Field ditches 3 of each ditch t do feet ditches 3 feet ditches 2H—# Z6 inches French Drain Required: Linear feet Authorized State Agent /%�i'i1�— /i1r���;� �O Date ____ Central Carolina Holdings Customer: 0369650001 / Larry Sharpes Generator: NA / Not Applicable Dest: DEST: CUSTOMER / Customer Truck: LARRY SHAR Comment Ticket: 1190937 Date: 5/l/2017 Time:13:41:52 - 13:58:57 Scale Gross: 41500 lb Out Manual Wt Tare: 22180 lb In Manual Wt Net: 19320 lb Origin Wastes & Sevices ------------------------------------------------------- NA / Not Applicable DFMT116/Drain Fill Material Weighmaster: Driver: Libby--Cgeron Quantity Unit Rate/Unit Amount ----------------------------------- 9.66 TON $25.00/TN $241.50 Total Taxes: $16.90 Total Amount: $258.40 lhs f^ -d -"r-^ chips Is from the Fuel Grade location and meets the Nc specification as star,:,: 11 JIlvo ylastowater system approval IWWS•2002.O3R for tiro chip Substituhu„ 4.1 Rook Appreyrato In Nitrification Flolds. 1aY 7 Al14 t 1aY 7