OPHTE# 1 -7 —")-7i6 Harnett County Department of Public Health 24747
PERMIT #a-�6❑S Operation Permit
'4Q A e+E ❑ Septic Tank )5� Nitrification Line ❑ Repair.11,Expansion
PROPERTY LOCATION: N50 Hous ass C%szc..,E
Name: (owner) flo "OWN -SUBDIVISION LOT #
System Installer »Aw E Registration #
Basement with plumbing. ❑ Garage ❑ Number of Bedrooms 3
Type of Water Supply: ❑ Community 'K Public ❑ Well Distance from well feet
System Type: �i a� 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.
norm taroona uenenl unnes, Runes mr )ewage reaumen( no visposal, no an mmmntom or one Improvemfnr rNmn ano tommumon mnnorionon.
I. Performance: System shall perform in accordance with Rule .1961.
ll. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ No
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
C')ssc llc,
Lle.& '�,00tp [l pr -->o 1yc.11(,p,oa
IN, V^Rl,2 OG"
QEOQgoshS
❑
D -Box ❑
Pump ❑ Alarm
❑ H201-ine
❑ PWR Line
Following are the
specifications for the
sewage disposal system on the above captioned property.
Type of system:
❑ Conventional
Other 'sn.6 GAPS
Septic Tank: ExsS id C gallons
Pump Tank gallons
Subsurface
No. of
exact length
width of
depth of
Drainage Field
ditches I
of each ditch feet
ditches .3 feet
ditches ia- I inches
French Drain Re linear feet
s
Authorized State Agent F_N Date
Central Carolina Holdings
Customer: 0369650001 / Larry Sharpes
Generator: NA / Not Applicable
Dest: DEST: CUSTOMER / Customer
Truck: LARRY SHAR
Comment:
Origin Wastes & Sevices
-----------------------------------------------------
NA / Not Applicable DFMT116/Drain Fill Material
Ticket: 1292371
Date:1O/2/2017
Time:15:47:58 - 16:05:53_
Scale
Gross: 40100 lb Out Manual Wt
Tare: 22040 lb In Manual Wt
Net: 18060 lb
J
Weighmaster: " Driver:
%Libby Cameron
Quantity Unit Rate/Unit------Amount
------------------------
9.03 TON $25.00/TN $225.75
Total Taxes: $15.80
Total Amount: $241..55
This load of tim chins is from th Fasi , rada ko-:±:_n and meets tho Nc specification as
stated in Innovalive V+astewater systam approvui IWWS-2002-03R for tire chip
SuNdution for Rock Aggregrate in Nitrification Fields.