OPHTE# F7 "S' U0-%�� Harnett County Department of Public Health 24740
PERMIT # 3) Operation Permit
New Installation �V Septic Tank X Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:_ Cuo.s .T-iics t.,sn
Name: (owner) Da -or -G Ncs^O-5 SUBDIVISION LOT #
System Installer: Gta,tin Registration #
Basement with plumbing: ❑ Garage ANumber of Bedrooms
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: l 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.
IMS system has been imtalled 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:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
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CVAM1V 63 =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 sewage disposals stem on the above captioned property.
Type of system: 1:1 Conventional Other E-7— Vl,ey Septic Tank: s 6 0 O gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field dlkthes�_ of each ditch IV V' feet ditches _— feet ditches 1a�3 0 inches
French Drain Regl ear feet
Authorized State Agent V7&4S Date