OPHTE# I - s -vrayG Harnett County Department of Public Health 24829
PERMIT # 7-1V91l 0 eration Permit � �
lew Installation eptic Tank [�Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: -1/o czoeesh,r P�rlt tom. Cs� /vos�
Name: (owner) 7 ^un,g, t-k,aw. Prrs cLcJ SUBDIVISION co,4s6�,: LOT # 79
System Installer: .?ti Qac Registration #
Basement with plumbing. ❑ Garageumb r of Bedrooms 3
Type of Water Supply: I—]Communityf�Public ❑ Well Distance from well feet
System Type: 35k� Ife<l-�X.r1' 5 er Types V and VI Systems expire in S years.
(In accordance with Table V a) 4wreermust contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Carolina General satires, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
PERMIT CONDITIONS
I. Performance: System shall perform in accordance with Rule .1961.
If. 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:
Other:
❑
D -Boz
I� sr 17s
D
5,t
the sewage disposal system on the above caption it
16
30n 5Ca) �/.a
ski
l�ther %� _G c' E.
— $a C3
Subsurface
'�$`lu ILc iT.cTic.s
P
2Cng12
Drainage Field
ditches
of each ditch feet
ditches _� feet ditches yX inches
C�✓E.s3.�2Y
PIs, . K_
PERMIT CONDITIONS
I. Performance: System shall perform in accordance with Rule .1961.
If. 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:
Other:
❑
D -Boz
❑ Pump ❑ Alarm
❑ H2OLine ❑ PWR Line
Following are the specifications for
the sewage disposal system on the above caption it
Type of system:
❑ Conventional
l�ther %� _G c' E.
Septic Tank: /GrX� gallons Pump Tank: gallons
Subsurface
No. of
exact length
3 60
width of depth of
Drainage Field
ditches
of each ditch feet
ditches _� feet ditches yX inches
French Drain Required: Linear feet
Authorized State Agent ,�'_Date 1 51 o
"UL UP
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