OPHTE# D 5 `la 3 Harnett County Department of Public Health 25055
PERMIT # a�$� 0 eration Permit
New Installation Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: N Cal o SO ul")
Name: (owner) (P6A T)LL�P �°`-4 sou e -&P SUBDIVISION LOT #
System Installer. JO fi7 S�pc tL Registration #
Basement with plumbing: ❑ Garage �iir Number of Bedrooms
Type of Water Supply: ❑ Communi ❑ Public X Well Distance from well feet
System Type: c Types V and VI Systems expire in S years.
(In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
has been installed
TH N'Y�
I. Performance: System shall perform in accordance with Rule
H. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑
If yes, see attached sheet for additional oper
IV. Operation:
V. Other.
too' a',s 3 oec?
U-11
conditions, maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑
Permit and construction Authurixation.
H2OLine ❑
PWR Line
Following are the specifications for the sewage disposal system on the above wpti�ed property. gallons
Type of system: El Conventional Other ��'��F� �' Septic Tank: 1 �� gallons Pump Tank
Subsurface No. of exact length width of depth of
Drainage Field ditches
s i of each ditch feet ditches 3 feet ditches 1$ inches
French Drain Required: Linear feet
'horized State
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