OP RRHTE# Harnett County Department of Public Health 25121
PERMIT # Z` -1S -7Z Operation Permit
New Installation Septic Tank d Nitrification Line ❑ Repair ❑ Expansion
� PROPERTY LOCATION:--iCf4i6A Aw-,oxas C4Leo9.c_,
Name: (owner) r IAr� �%An.r(�� SUBDIVISION LOT # )
System Installer: n Fac, -1 Registration #
Basement with plumbing: ❑ Garage � /' umber of Bedrooms 3 P
Type of Water Supply: ❑ Community Ls! Public El Well Distance from well feet P 1 069 ( 031 L 01
System Type: aI�. %yo. TT—r- Types V and VI Systems expire in S years.
(In accordance with Table V a) Zvi
must &tact Health Department 6 months prior to expiration for permit renewal.
AU.3e
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
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
� DS
$nYZ
yp 3 3w
(90 `
� I
3t. J30% S �
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 ❑ 1-12O1-ine ❑ PWR Line
Following are the specifications
for the sewa disposal system on the above captioned property.
Type of system: ❑
Conventional Other
-1- 1v
Septic Tank: 1000 gallons Pump Tank: gallons
Subsurface
No. of
exact length
width of depth of „
Drainage Field
ditches
of each ditch feet
ditches 3 feet ditches IL inches
French Drain Required:
Linear feet _
Authorized Stav —�cr[ t.��'
Apt:nt_� -Y� Date
17-541608RR (1)
17-5-41608RR (2)
17-5-41608RR (3)
17-5-41608RR (4)
17-5-41608RR (5)
17-5-41608RR (6)
17-5-41608RR (7)
17-5-41608RR (11)
17-5-41608RR (12)
17-5-41608RR (8)
17-5-41608RR (9)
17-5-41608RR (10)