OPHTE# (2 - - u qy Harnett County Department of Public Health 25124
PEAMIT # Z2 Operation Permit
E�-2"
f�w Installation Septic Tank Id" Nitrification Line ❑ Repair El Expansion
PROPERTY LOCATION52/y/Ejt-4,�A 1�4�,trd/ t?Z
Name: (owner) v SUBDIVISION LOT #
System Installer: Registration #
Basement with plumbing: ❑ Garage ❑�Number of Bedrooms
Type of Water Supply: ❑ Community r? Public ❑ Well Distance from well feet
System Type: --j 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.
a&47
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:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
yi
l
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other.
Subsurface system operator required.! Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑
H2O1-ine ❑
PWR Line
Following are the specifications for the sewa disposal �systjem non�yteh�e 'a,bove captioned property.
Type of system: ❑ Conventional 71 ther /�6 /�W GRJI�__ Septic Tank: I Z'SD gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches �2— of each ditch 00 feet ditches_ feet ditches 20,a
inches
trench Drain Required: Linear feet
Authorized State A ,.i T Date -7-- r
v
17-5-42244 (1)
17-5-42244(6)
17-5-42244 (2)
17-5-42244 (7)
17-5-42244 (3)
17-542244 (4)
17-5-42244 (5)
17-5-42244 (8)
17-5-42244 (11) 17-5-42244 (12) 17-542244 (13)
17-5-42244 (9)
17-5-42244 (10)