OPHTE#/G�- �=yotls7 Harnett County Department of Public Health 24788
PERMIT #-29 / E38 Operation Permit
❑/ New Installation Septic Tank lil/ Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATI e'5 /a
Name: (owner) SUBDIVISION c ~ LOT # 3,S—
System Installer: Registration Registration #
Basement with plumbing. ❑ Garage Ef Number of Bedrooms 3
Type of Water SuppIL ❑ Community Q Public ❑ Well Distance from well feet
System Type:,�/T fy 5 l;� i%�E Zypes V and YI Systems expire in S years.
(In accordance with Table Y a) i . Owner must contact Health Department 6 months prior to expiration for permit renewal.
this system has been imtalled In compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
PERMIT CONDITIONS
I. Performance:
Il. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
nl�
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 ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewj(e disposal system on the above captioned property.
Type of system: ❑ [onventional [�1 Other 15%a sl. sf/�-- Septicrank / �cx� gallons Pump Tank / ° y gallons
Subsurface No. of exact length width of depth of t ,
Drainage Field ditches of each ditch �dD feet ditches feet ditches hes
French Drain Required: Linear feet
Authorized Sta6Jizent — ill l ' Date
qK �
16-5-40457 (1) 16-5-40457 (2) 16-5-40457 (3) 16-540457 (4) 16-5-40457 (5)
4
16-5-40457 (6) 16-540457 (7) 16-5-40457 (8) 16-540457 (9) 16-540457 (10)
t
16-5-40457 (11) 16-5-40457 (12) 16-540457 (13) 16-5-40457 (14) 16-540457 (15)
16-540457 (16) 16-5-40457(17) 16-5-40457(18) 16-5-40457(19) 16-540457 (20)
.r. .I
16-540457(21) 16-5-40457 (22)