OPHTE#/0 - z'i3Z3 Harnett County Department of Public Health
PERMIT Operation Pe It 21 7 2 3
2 /New Installation Seatic Tank Nitrification Line ❑ Reoair ❑ Expansion
PROPERTY LOCATION: jg3q E/L,
Name: (owner) SUBDIVISIONS. - LOT #
System Installer: 4D 65t , ~ Registration #
Basement with plumbing: ❑ Garage 21umber of Bedrooms
Type of Water Supply: ❑ Community V public ❑ Well Distance from well feet
System Type: zQtr) -5 1t.,r ~~-C' f-"Types V and VI 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
N.) Lz% oc )
with applicable North Larolma heneral Statutes, pules for sewage treatment and uisposai, and an condmons m me improvement rermit ana construction autnoraation.
12
PERMIT CONDITIONS:
1. Performance: System shall perform in accordance with Rule .1961.
II. Monitoring: As required by Rule .1961.
Ill. 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 ❑ H20Line ❑ PWR Line
Following are the specifications for the sews disposal stem on the above captioned property.
Type of system: ❑ Conventional Eir Other Z`5ffi1v Septic Tank: WO gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch feet ditches feet ditches Z`>? inches
French Drain Required: Linear feet
Authorized State Ag - Date 3-11-11
~
.Y. ~..s
ti
r
t
.
.
y L ~ fR . ~ ~r Ge.. • kk_
f
• k ~ r ka Id r: ~ k ~ 'r ~
C S'} ~
r
At
,
.
ti
a
A 777777771 '7777 77
r.yy tx ~ ~ ~ ~t 3 ~I Y~'. u11
_ a 1 t y~ ~ i G F~
Y f
-E 'Y nE t
~s Ir
q; < r -
J x
zr~
° k rqy e~ y. 3Y ~ w -
77
, I Au
MOP
71
'mss - ";~5 .3 •a
T
K 3 " yowl
ell
•l i, f`'`~`' S,~ "A ) r '~~p 11 $a'+`~ alp. Y
Vol wif
Ayc'
A ANY
v~. y ti t J hr L 1 i 3 w
c fib. 'Q~y,
~'2 v.. \ i S j
os
J'e
.J
q ! l~' 3F Woo 1 1