OP RHTEHarnett County Department of Public Health 24807
PERMIT# /Operationa'Septi /
New Installation C� Septic Tank r�Nitrification Line ❑ Repair ❑Expansion
PROPERTY LOCATION 4/L Com► /1„d
Name: (owner) A,1 a tii.,.T.�� SUBDIVISION LOT #
System Installer. / Registration #
Basement with plumbing: ❑ Garage Aumber of Bed oms
Type of Water Supply: ❑ Community Public ❑ Well Dsstance from well feet
System Type: Types V and VI Systems expire in S years.
(In accordance with Table V a) Owner must c 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 Authorization
I
r
PERMIT CONDITIONS
I. Performance: System shall perform in accordance with Rule .1961.
11. 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 -Box ❑ Pump ElAlarm ❑ H2OLine ElPWR Line
Following are the specifications for the sewsgi disposal system on the aba ca tioned property.
Type of system: ❑ Conventional f7 OtheSeptic Tank: 1 ZSb gallons Pump Tank: gallons
Subsurface No. of exact length l width of depth of
Drainage Field ditches of each ditch feet ditches 3 feet ditches C-1 inches
French Drain Required: Linear feet
Authorized State A Date
16-540144R (1)
16-5-40144R (2)
16-5-40144R (3)
16-5-40144R (4)
16-540144R (5)
16-5-40144R (6)
16-540144R (11)
16-5-40144R (7)
0
16-5-40144R (12)
16-5-40144R (8)
16-5-40144R (9)
16-5-40144R (10)