OPHTE# ll� '4Z9sy Harnett County Department of Public Health 24808
PERMIT# eration Permit
New Installation Septic Tank 0 Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOfATION:
Name: (owner) 7'R ..%NG SUBDIVISION LOT #
System Installer: G Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms
Type of Water Supply: ❑ Community f u is ❑ Well Di nce from well feet
System Type: 2aa- [Z �i' T I 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 compliance with applicable Month Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and construction Authonaation
9glillaFOlUIT1DIIS+.
I. Performance:
If. 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 -Boa ❑ Pump ❑ Alarm ❑
H2OLine ❑
PWR Line
Following are the
specifications for the
sewa disposal system on the above captioned property.
Type of system:
❑ Conventional
7ther P 4" C'&�
Septic Tank: 1!!N� gallons Pump Tank: gallons
Subsurface
No. of
I
exact length
width of depth of
3 Ig
Drainage Field
ditches
of each ditch2�7h feet
ditches feet ditches inches
French Drain Required: Linear feet
Authorized State A %�ii Date l` I
17-5-42954 (1)
17-5-42954 (6)
17-5-42954 (2) 17-5-42954 (3) 17-5-42954 (4) 17-5-42954 (5)
It's
17-542954 (7) 17-5-42954 (8) 17-5-42954 (9) 17-5-42954 (10)
17-5-42954 (11)
17-5-42954 (12) 17-5-42954 (13)
j2+'
17-5-42954 (16) 17-5-42954 (17) 17-5-42954 (18)
_ f �
n I
17-5-42954 (14) 17-5-42954 (15)
Y 17-5-42954 (19)_`�