OPHTE# / s 01_192 Harnett County Department of Public Health 24499
PERMIT # 2915& j O eratl0n Per It
C� New Installation Septic TankNitnrication Line ❑ Repair ❑ Expansion
PROPERTY LOCATION 3--'r
Name: (owner) - )5PAjz_lpq 4 U SUBDIVISIONLOT # 1�
System Installer: Registration #
Basement with plumbing: ❑ Garage ff tuber of Bedrooms
Type of Water Sumly: ❑ Communi Public ❑ Well Distance from well feet
System Type: d Types V and A Systems expire in S years.
(In accordance with Tae V a) Owner m st contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with ppliable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authoritarian.
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
Other.
H ->s,- 6� L'A)
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 s to on the above captt ed
roperty.
Type of system:
El Conventional [is Other
ZF�D /7_�1—f]IiL/ /40^1
Septic Tank: J ooh gallons Pump Tank: gallons
Subsurface
Drainage Field
No. of
ditches
exact length
of each ditch 2D feet
width of depth of q
ditches 3 feet ditches inches
trench Drain Required: Linear feet
Authorized State A 7??8 Date—� /�
maim __r
16-5-40292 (1) 16-5-40292 (2) 16-5-40292 (3) 16-5-40292 (4) 16-5-40292 (5)
16-5-40292 (6) 16-540292 (7) 16-5-40292 (8) 16-5-40292 (9) 16-5-40292 (10)
16-5-40292 (11) 16-5-40292 (12) 16-5-40292 (13) 16-5-40292 (14) 16-5.40292 (15)
16-5-40292(16) 16-5-40292(17) 16.5.40292(18) 16.540292(19) 16-5-40292(20)
mmm
16-5-40292 (21) 16-540292 (22) 16-5-40292 (23)