OPNTE# i 2-- 4;W3 Harnett County Department of Public Health 25035
PERMIT # 2,�1-153 Operation Permit
New installation "R Septic Tank � Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: rJG a`1
Name: (owner) _[LCAT s> Z L 0N-4ea-VJF, SUBDIVISION LOT # 3
System Installer: L-Lt3, -DoQ Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms 3
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: STT 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.
This system has been installed in rompliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
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PERMIT CONDITIONS
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. 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 ❑ Nox
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑
H2OLine ❑
Following are the specifications for the sewage disposal system on the also a capti d property.
Type of system: ❑ Conventional Other %sins+ GI54— di Septic Tank: 100 G gallons Pump Tank:
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch aT 4d feet ditches —4 feet ditches
French Drain Required: Linear het
Authorized State Agent Date 31A B
PWR Line
gallons
inches
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