OP RRRNTE# Harnett County Department of Public Health 24735
PERMIT # ��1SLl�i Operation Permit
❑ New Installation �K Septic Tank �X Nitrification Line ❑ Repair XExpansion
I PROPERTY LOCATION: ?,, rMs Rs
Name: (owner) QL)r.ch L.ocL6o i �<—G1NP, SUBDIVISION LOT #
System Installer: kErNEra \4o—L&t5 Registration #
Basement with plumbing: ❑ Garage ❑ Number of -&&&-As 17C)
Type of Water Supply. ❑ Community `C Public ❑ Well Distance from well 1 CO feet
System Type: ijZ - 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 ith applicable Nord) Carolina-Genetal Statut"ides lor5ewageireatm nt and Disposal, and all conditions of the Improvement Permit and construction Authorization.
i
f
wOop ij
__rte
Nlv r
1 ..
ryr Ip
$f'
S OC7
PERMIT CONDITIONS:
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ Nox
If yes, see attached sheet for additional operation conditions, maintenance and reporting
V. Other. tJ o a -D P,Ep `NFp \� E. UA wov" t
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property. 1y,$3
Type of system: ❑ Conventional X Other EZ.FLa'N Septic Tank: 1000 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage FieldI Jr of each ditch %S feet ditches feet ditches 119-��L`l inches
French Drain Require - a� Linear feet
Authorized State Agent_ V4—u Date
G- s— 3c, oaS'