OPHTE# 17 -5 --WO -7 Harnett County Department of Public Health 24817
PERMIT # 2'X/y_ Operation Permit
0 New Installation 0-�epfic Tank LYNitnfication Line ❑ Repair ❑ Expansion
PROPERTY LOCATION• /
Name: (owner)SUBDIVISION, LOT # 1
System Installer. Registration #
Basement with plumbing. ❑ Garage Number of Bedrooms 3
Type of Water Supply: ❑ Community ❑4ublic ❑ Well Distance from well feet
System Type: 6 Types V and VI Systems expire in S years.
(In accordance with Table V a) Owner must col 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.
runrrtn s.vnmmmi.
I. Performance: System shall perform in accordance with Rule .196.
IL 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 -Boz ❑ Pump ❑ Alarm ❑ 112O1-ine ❑ PWR Line
Following are the specifications for the sews,g� disposal system on the above captioned property.
Type of system: ❑ Conventional L' Other%S%a/WA0Gi7,n Septic Tank: 00U gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches �_ of each ditch g010 feet ditches feet ditches inches
French Drain Required: Dnear feet
r7
Authorized State Age �_/�[,�—i Y �'� Date 6y —7 -�/Ud
17-5-42087 (1) 17-542087 (2) 17-542087 (3) 17-542087 (4) 17-5-42087 (5)
17-5-42087 (6) 17-5-42087 (7) 17-5-42087 (8) 17-5-42087 (9) 17-542087 (10)
m M-
1 �
17-5-42087(11) 17-5-42087(12) 17-5-42087(13) 17-5-42087(14) 17-542087(15)
17-542087 (16) 17-5-42087 (17) 17-542087 (18) 17-5-42087 (19)