OPHTE# I:� 41,,,, y Harnett County Department of Public Health 24514
PERMIT # ZC(,Cj! 0 eration Prerm, it
New Installation Septic Tank Nitrification Line ❑ Repair Expansior
PROPERTY LOCATION: Pki Lf Li Z
Name: (owner) 7UiL jp .1e /eAAc0& 15 SUBDIVISION LOT #
System Installer: Registration #
Basement with plumbing: ❑ GaAge 9 dumber of Bedrooms d
Type of Water Supply: ❑ Community l3( Public ❑ Well Distance from well feet
System Type: T Types V and VI Systems expire in 5 years.
(In accordance with Table V a) t r must co ct Health Department 6 months prior to expiration for permit renewal.
This system has been insulted in compliance wnb applicable Norm Carolina General lmtutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement eermn and tomtrucnon AU0nm2Gon.
15 L Z
I
Lc
30 �\
� n �
U ir.L_rtze E,Sn.�
PERMIT CONDITIONS
I. Performance:
fl. Monitoring:
111. Maintenance:
IV. Operation:
V. Other.
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 ElH2OLine
ElFollowing
are the
specifications for the
sewa disposal system on the above captioned property.
p�a�
Type of system:
❑ Conventional
Other 7570 �/_'DD 4rltr--
Septic Tank: 10 0 O gallons
Pump Tank:
Subsurface
No. of
exact length
width of
depth of
Drainage Field
ditches .3
of each ditch 90 feet
ditches 3 feet
ditches _
French Drain Retuned:
Linear feet
Authorized StateAeew'_/ / 1,'1 -7 -kA -t% Date c-5-7_/,
PWR Line
00 U gallons
18rr
inches
17-5-41774 (1)
PF -M r r.,•
G _R
17-5-41774 (6)
17-5-41774 (11)
17-5-41774 (2)
17-5-41774 (7)
17-5-41774 (12)
17-5-41774 (3) 17-5-41774 (4)
6;
b
17-5-41774 (8)
17-5-41774 (13)
17-5-41774 (5)
17-5-41774 (9)
17-5-41774 (10)