OPHTE# t4-5= 31615th Harnett County Department of Public Health 24494
PERMIT # Z O' /0 eration Per It /Nitrification
New Installation Septic Tank Line ❑ Repair ❑ Expansion
PROPERTY LOfAT10 a:f(- N/9 /0 ✓--
Name: (owner) SUBDIVISION Z4, e.J Xao LOT # S
System Installer. egistration #
Basement with plumbing: ❑ Garage mber of Bedrooms 3
Type of Water ply: ❑ Community Public ❑ Well Distance from well feet
System Type: , /(ate r=QCs Types V and VI Systems expire in S years.
(In accordance with Tible V a) / Own= us�ealth Department 6 months prior to expiration for permit renewal
This 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
PERMIT CONDITIONS
I. Performance:
Il. Monitoring:
111. Maintenance:
IV. Operation:
V. Other.
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fax- F.z..ral
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System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewa disposal systyp,aq the` b s'F captioned prop rly. ,,��yy��
Type of system: ❑Conventional Other U '/M S/ Septic Tank: gallons Pump TanVr:-' d gallons
Subsurface �ditches
exact length width of depth of a/
Drainage Field of each ditch SD feet ditches J feet ditches Z+Z inches
French Drain Recanted:Linear feet
Authorized State Agent 'i y�� Qr�AS Date 8
16-5-38154 (1)
16-5-38154 (2)
16-5-38154 (3)
16-5-38154 (4)
16-5-38154 (5)
16-5-38154 (6)
16-5-38154 (7)
16-5-38154 (8)
16-5-38154 (11) 16-5-38154 (12) 16-5-38154 (13)
16-5-38154 (9)
16-5-38154 (10)
16-5-38154 (1)
16-5-38154 (2)
16-5-38154 (3)
16-5-38154 (4)
16-5-38154 (5)
16-5-38154 (6)
16-5-38154 (7)
16-5-38154 (8)
16-5-38154 (11) 16-5-38154 (12) 16-5-38154 (13)
16-5-38154 (9)
16-5-38154 (10)