OP RHTE# t 7��7 f 1� Harnett County Department of Public Health 24892
PERMIT # 2'14706 Operation Permit
X New Installation )Septic Tank X Nitrification Line El Repair E3 Expansion
\, PROPERTY LOCATION: Ea-reCs.: C-Avr10%N 'QP
Name: (owner) vsvN SUBDIVISION �afo-7uc"NNVTof- LOT # G
System Installer: G+H Q>pc RxioE Registration #
Basement with plumbing: El ❑ Number of Bedrooms 3
Type of Water Supply: ❑ Community ❑ Public X Well Distance from well feet PEa >t�aQEA
System Type:.TiT Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
YERMII EUNUIIIONS:
I. Performance: System shall perform in accordance with Rule .1961.
If. Monitoring: As required by Rule .1961.
111. 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. EF—t- '46a4_ 1rt !P+t, '0 F_" 1Naorl,rwttdas
❑ —D -Box ❑ Pump ❑ Alarm ❑
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional X Other E -Z VLC W Septic Tank:
Subsurface No. of exact length width of
Drainage Field ditches 3 of each ditch '90 feet ditches _
H2OLine ❑ PWR Line
1600 gallons Pump Tank: gallons
depth of
3 feet ditches aL)i inches
French Drain Required: Linear feet
Authorized State Agent R� S Date S 10 1,?