OPHTE# 1:1 s— t%► a)%
Harnett
County Department of Public Health
24512
PERMIT # 536
Operation Permit
❑ Repair ❑ Expansion
Lf New Installation Tank Nitrification Line
PROPERTY LOCATION: 4Z5
44-3
Name: (owner)
SUBDIVISION
LOT #
System Installer: 7 Yo&tjTZ-)1
l?j t/ »--tie�,-c
Registration #
Basement with plumbing: ❑ Garage
U/ Number of Bedrooms c') 6
feet
Type of Water Supply: ❑ Community
System Type: Zk D -.0& -g
I.+J Public ❑
Sz s 4-4,
Well Distance from well
w. C G nl�fypes V and VI Systems expire in S years.
(In accordance with Table V a)
Owner mustct th Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Carolina General Statutes, Rules f:AL ' Treatment and nsooal and all conditions of the Improvement Remit and construction Authorization
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
Other:
V
`C& y
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 a disposal system on the above captioned properly.
Type of system: ElConventional f Other L5 iZa/> crGlrZJ �i�S%i Septic Tank: i ZSR gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches_ of each ditch 3a feet ditches -3 feet ditches ZZ --7 8 inches
French Drain Required: Linear feet
f7^
Authorized State A¢e6t .V� �4-ut-✓t>, �� Date Z
17-5-01019 (1)
17-5-41019 (2)
17-5-41019 (3)
17-5-41019 (4)
17-5-41019 (5)
17-5-41019 (6)
17-5-41019 (8)
17-5-41019 (9)
17-5-41019 (11) 17-5-41019 (12) 17-5-41019 (13)
17-5-41019 (14)
17-5-41019 (10)