OPHTE# Ii -5- L-0061 Harnett County Department of Public Health 25081
PERMIT # 01 Operation Permit ��,{
New Installation IR Septic Tank +tel Nitrification/ -L�ine� ❑ Repair ❑ Expansion
PROPERTY LOCATION: SP2aN6 HNtiL `-at's0`ZL0
Name: (owner) S16Nacu(Zk, Hc),,4 SUBDIVISION LOT #
System Installer. GE—to 12nra.ccHcis b Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms 4
Type of Water Supply: ❑ Community_ Public ❑ Well Distance from well feet
System Type: AIL L h Types V and VI Systems expire in S 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 compli With appbpble North tarohna beneral ftatutes, Rules lot Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
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I'Mil I.URUIIIM:
I. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .196f. Other.
Subsurface system operator required? Yes ❑ Nox
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2O1-ine ❑ PWR Line
following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional Other EZ Fto u Septic Tank: 100 U gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch 160 feet ditches 3 feet ditches T� inches
French Drain Reauired: Linear feet
Authorized State A¢ent 112-vo3 Date