OPNTE# /6-2�=39759 Harnett County Department of Public Health 24801
PERMIT # 9108q Operation Permit �
� New Installation Septic Tank 2 Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LO[ATIONQyy _T' 4Vu e adG
Name: (owner) Ci SUBDIVISION iUG��3 LOT # -73,V
System Installer: T ' Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms
Type of Water Sug,pjy: ❑ Community a Public ❑ Well Distance from well feet
System Type: wbl w�67,L , of 17 weer Types Y and VI Systems expire in S years.
(In accordance with able Owner tact Health Department 6 months prior to expiration for permit renewal.
" I.
installed in compliance wits applicable North Carolina General Statutes -Ides for Sewage Treatment ad Disposi and all conditions of the Improvement Permit and Construction Authorization.
S/t Y��V �JRYhaj /wtiawwo
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 ❑ 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 sewage disposal system on the above captioned property.
Type of system:
❑ Conventional ❑
Other Z M,6 1�rZaSt_.
Septic Tank 0 gallons Pump Tank: t QO C5 gallons
Subsurface
No. of
Z
exact length
width of depth of
Drainage Field
ditches
1
of each ditch /D feet
ditches 3 feet ditches 94-2 VS inches
french Drain Required: linear feet
Authorized State Agent Date c4lu 12016
R Y �
r
16-5-39759 (2) 16-5-39759 (3) 16-5-39759 (4) 16-5-39759 (5) 16-5-39759 (6)
mow
16-5-39759 (7) 16-5-39759 (8) 16-5-39759 (9) 16-5-39759(10) 16-5-39759(11)
r �
,1
16-5-39759 (12) 16-5-39759(13) 16-5-39759(14) 16-5-39759(15) 16-5-39759 (16)
16-5-39759 (17) 16-5-39759(18) 16-5-39759(19)