OPHTE# 1 -1 -5-9ms / Harnett County Department of Public Health 24860
PERMIT # a 15i'R Operation Permit
❑-1& Installation Er 'Geptic Tank bion Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: 2asa M•all1+ t a . Csa f0s:)
Name: (owner) SUBDIVISION aha x LOT # 3
System Installer: e -%,I A,c ca Registration #
Basement with plumbing: ❑ Garageumber of Bedrooms 44
Type of Water Supply: ❑ Community 9-1rub—lic ❑ Well Distance from well /✓h feet
System Type: Ll 5 . Re A c L ry n s s . :2�7_ Types V and VI Systems expire in 5 years.
(In accordance with Table V a) wner must contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable north Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authontabon
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PERMIT CONDITIONS
I. Performance: System shall perform in accordance with Rule .1961.
H. 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:
V. Other.
❑ D -Boz ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage sal system on the above captioned property.
Type of system: ❑ Conventional EkIther J' i--Ics J `_Lla Septic Tank: 1000 gallons Pump Tank gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch GU feet ditches 3 feet ditches IP) inches
French Drain Required: Linear feet
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