OPHTE# V? -5J' LI c 1 Harnett County Department of Public Health 25074
PERMIT # D7f-4Zt1 Operation Permit
X New Installation 'C�t' Septic Tank Nitrifica ion Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:
Name: (owner) MaggiL V2a5`-socz:'N SUBDIVISION LOT #
System Installer: C.t_t 4-visv Qoo,o Sros t; Registration #
Basement with plumbing: ❑ Garage ❑ Number of Be rooms 3L m I
Type of Water Supply: El Community ❑ Public Well Distance from well 5 d feet
System Type: d Types V and VI Systems expire in S years.
(In accordance with Table V a) 1 Owner must contact 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
PERMIT CONDITIONS
I. Performance:
11. 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 ❑ Noo
If yes, see attached sheet for additional operation ca
maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑
S � a`aA6 C
1-12O1-ine ❑
PWR Line
Following are the specifications for the sewage dispos system on the above ca tion property.
Type of system:
El X Other wgM�GQL.IQ Septic Tank: 166 0 gallons Pump Tank: gallons
Subsurface No. of exact length width ordepth of
Drainage Field ditches of each ditch G a feet ditches 3 feet ditches �g inches
French Drain Returned: _ I wear feet
Authorized State Agent RG -10 Date 4114 )g
J
/ '�"
j_y
c�. ,
F�
F �
4 � f ��; ,
3 � r" '
t;
� � �
R
'.i
it
� � �'�
�:
4 S :. #:
a> #-
,.
j,e
�`
� .
l�
�' of
a
�.
.4,
��
o ,..
i -.
�s 4
!' _
r��
s-
c�. ,
F�
F �
4 � f ��; ,
3 � r" '
t;
� � �
R
'.i
it
� � �'�
�:
4 S :. #:
a> #-
,.
j,e