OP RHTE# 17'5-'-1Z-72 v/Z Harnett County Department of Public Health 25122
PERMIT# 2`)t Z9 / Operation Per It
Ed New Installation Septic Tank 2/Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:.Art / 44 y C -t 42 //e3
Name: (owner) Com/ F� (7 SUBDIVISION LOT #
System Installer: n Registration #
Basement with plumbing: ❑ Garage IT Number of Bedrooms 3
Type of Water Su�p��Iyy: ❑ Community Public ❑ Well Distance from well feet
System Type: i `i ifu Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must contact �Heegalthh�Department 6 months prior to expiration for permit renewal.
d
This system has been imtalled in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
lii d3 soC.—
4pr I
i
s2 14q C 4 I,E)e� P_b
FLKMII LUNDIIIDN):
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 ❑ Alarm ❑ H2OLine
❑ PWR Line
Following are the specifications for the sew a disposal system on
sewab/ovye captioned property.
Type of system: ❑
qthe�
Conventional -a.
Zfj! d'ILlG/1 .ems-�-.—
Septic Tank: ! ao-y gallons
Pump Tank: gallons
Subsurface
No. of exact length
width of
3
depth of
Drainage Field
ditches —3 of each ditch 6 feet
ditches feet
ditches -3 inches
French Drain Required: Linear feet
Authorized State A Date
Lj
NEW
Am
- O -LI,
17-5-42724R (6) 17-542724R (7) 17-5-42724R (8) 17-5-42724R (9) 17-5-42724R (10)
Ab
17-5-42724R (11) 17-5-42724R (12) 17-5-42724R (13) 17-5-42724R (14) 17-5-42724R (15)