OP RHTE# `q —S- 41193¢— Harnett County Department of Public Health 24853
PERMIT # a931a Operation Permit
El-lew Installation Ic ank El.-Nitrifitifion Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:_ 131 &4 acs e— Oc. ( Q—cAki ns " . S 2 1 Y 113)
Name: (owner) SUBDIVISION —r L.- (z. --,e LOT # 9
System Installer. ? Registration #
Basement with plumbing: ❑ Garage LYIumber of Bedrooms
Type of Water Supply: ❑ Community ❑61�O -PDWell Distance from well . 4 feet
System Type: 2%i4 ,r -b 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.
This system has been installed in compliance with applicable North Carolina General Summit, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
PERMIT CONDITIONS
I. Performance:
ll. Monitoring:
III. Maintenance:
IV. Operation:
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 ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sewage di I system �on\ the above captionedro�rly.
Type of system: ❑ Conventional lher l aA1Q A� S� T 1> Septic Tank: Ice gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of -//
Drainage Field ditches of each ditch T Sd feet ditches_ feet ditches ���//inches
French Drain Required: Linear feet p
Authorized State Agen r / � Date /—/6—/ 8
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PERMIT CONDITIONS
I. Performance:
ll. Monitoring:
III. Maintenance:
IV. Operation:
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 ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sewage di I system �on\ the above captionedro�rly.
Type of system: ❑ Conventional lher l aA1Q A� S� T 1> Septic Tank: Ice gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of -//
Drainage Field ditches of each ditch T Sd feet ditches_ feet ditches ���//inches
French Drain Required: Linear feet p
Authorized State Agen r / � Date /—/6—/ 8