OPHTE# 't,—S —s So(. q
PERMIT # 0607
Name: (owner)
System Installer: / DA
Basement with plumbing. d
Type of Water Supply: ❑ Co
System Type: 75'2� /e
(In accordance with Table V a)
Harnett County Department of Public Health 24781
O erati� on Permit
LJ Neww Installation Septic Tank Nitrification Line ❑ Repair ❑Expansion
PROPERTY LOCATION e -A/D 3 .eA
SUBDIVISION t7e rLOT # __
Registration #
araV 13mbeeof Bedrooms 5
uty Lir Public ❑ Well Distance from well feet
�.TL ito.�rr
i•� g7� G Types V and VI Systems expire in S years.
Usher must ccoo'nt�actt Health Department 6 months prior to expiration for permit renewal.
with applicable North Carolina General Statutes, Rules ape irFatment and Disnosal, and all conditions of the Imorovencent Pennit and Constmaion As
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veS _
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I. Performance: System shall perform in accordance with Rule .1961.
II. Monitoring As required by Rule .1961.
Ill. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, n
IV. Operation:
V. Other.
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and reporting.
M
❑ D -Box ❑ Pump ❑ Alarm ❑�vy
ri ° HO2"OLine ❑ PWR Line
Following are the specifications for the sewapee disposal system on the gbove captioned property. co �ai cc
Type of system: ❑ [onventional Other 75%a Septic Tank: / CO gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 3 of each ditch Joy feet ditches feet ditches LZ' inches
French Drain Required: Linear
feet
�y/�
Authorized State A en %--e9–' . _. / ' l/ yL93nV
g � _ Date / Z -.5'-
i
16-5-38064 (1)
16-5-38064 (2)
16-5-38064 (3)
16-5-38064 (4)
16-5-38064 (5)
16-5-38064 (6)
16-5-38064 (7)
16-5-38064 (11) 16-5-38064 (12)
16-5-38064 (8)
16-5-38064 (9)
16-5-38064 (10)