OPNTE# 13 --a100 Harnett County Department of Public Health 24696
PERMIT # 2q 566 Operation Permit
New Installation La'Te—ptic Tank 2r Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: 235 "ile Gula. (gr,cK ^.ti 26 5ct acwz5/
Name: (owner) ler ! 2ucnCiS SUBDIVISION col,lIe54n4e_ - Fc LOT # 23
System Installer. Pa C C r: Registration # I Ate,
Basement with plumbing: ❑ Garage luyber of Bedrooms
Type of Water Supply: ❑ Community ublic ❑ Well Distance from well feet
System Type: zsA, Types V and VI Systems expire in S years.
(In accordance with Table Y a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
This system has been imtalled in complianm with appliable North Carolina General Statutes, Rules for Sewage Treatment and Disposal. and all conditions of the Improvement Permit and Constmttion Authoma ion.
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PERMIT CONDITIONS -
I. Performance:
Il. Monitoring:
III. Maintenance:
IV. Operation:
Y. 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 0'
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑ H20Line ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned roperty.
Type of system: ❑ Conventional ❑-tiher Q4 C�ic r N Septic Tank s a'`SC> gallons Pump Tank gallons
Subsurface No. of..11 exact length T— width of depth of
Drainage Field ditches 7 of each ditch feet ditches 3 feet ditchesinches
trench Dram Required: Linear feet
Authorized State Agent Gr a � — G�-��>l /! � Date to too / RO i —+