OPHTE# j s -3s o Harnett County Department of Public Health 24804
PERMIT # 2WYO /0 eration Per It
IV New Installation Septic Tank Nitrification line ❑ Repair ❑ Expansion
) —_ (_� `> PROPERTY LOCATIONZ(— j-5)f1Z ��� tZIN
(owner) owner / SUBDIVISION
# DIVISION
System Installer: 066)*5 1f ' � LOT # —�
_�
Basement with plumbing: ❑ Garage�❑ her of Bedrooms _
Type of Water Supply: 01 Community I Public ❑ Well Distance from well feet
System Type:
(In accordance with Table V a) OwT ZtG eZ Types V and VI Systems expire in 5 years.
ner must can « Health Department 6 months prior to expiration for permit renewal.
mis system naz teen installed in compliance with applicable North Carolina General Statutes, Rules for Se a Treatment and Disposal, and all conditions of the Improvement Permit and Consuumon Authorization.
�l °
4
� l
I
t t5-0 VGNN r
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 ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting
❑ D -Box ❑ Pump ❑
�I
H2OLine ❑
Line
Following are the specifications for the sewa disposal system on the above captioned property.
Type of system: 11 Conventional ther ?'S°Jt, dLL40. e� Septic Tank: 166b gallons Pump Tank gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches q of each ditch 4PO feet ditches 3 feet ditches —7q —S fA inrhet
french Drain Required: linear feet
Authorized State %Ze, Date S —3 —/
16-5-38390 (1) 16-5-38390 (2) 16-5-38390 (3) 16-5-38390 (4) 16-5-38390 (5)
MMAMM
16-5-38390 (6) 16-5-38390 (7) 16-5-38390 (8) 16-5-38390 (9) 16-5-38390 (10)
16-5-38390 (11) 16-5-38390 (12) 16-5-38390 (13) 16-5-38390 (14) 16-5-38390 (15)
IN
N