OP RHTE # I'1—S�`//o/SP Harnett County Department of Public Health 24811
PERMIT # Z032-- 0eration Per 't
New Installation Septic TankNitrification Line ❑ Repair ❑ Expansion
PROPERTY LO(ATION:!!ic.
Name: (owner) — SUBDIVISIONLOT # Z3
System Installer: 1 Registration # _
Basement with plumbing: ❑ Garageumber of Bedrooms
Type of Water Su ply: ❑ Community Lte' Public 11 Well Dista njje from well feet
System Type: _ &-o—% Ike ��. ei. Types V and VI Systems expire in S years.
(In accordance with ble V a) TL. contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North caroti General/Statutes Rules for S—.. T— t Disposal, and all conditions of the Improvement Permit and Cunsnuaion Authorization.
PERMIT CONDITIONS:
I. Performance:
Il. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
0
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
❑ D -Box ❑ Pump ❑
maintenance and reporting.
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N," d ALAa.nt A. (,o REV rte? Iti
112OLine ❑
Following are the specifications for the seewwa�sposal system on t e abov captioned pro ty. 7 _
Type of system: ❑ fonventional E -K Other '�`%y 6J--j¢�tic Tank: z s gallons Pump Tank:�ZS �
Subsurface No. of exact length V D width of depth of
Drainage Field ditches _�of each ditch _�_ feet ditches 3 feel ditches
French Drain Required: Linear feet
Authorized State Agent ��2� Date
FAIR Line
gallons
nrhec
I - 1
17-541015RR (1) 17-5-41015RR (2) 17-5-41015RR (3) 17-541015RR (4) 17-5-41015RR (5)
17-541015RR (6) 17-541015RR (7) 17-5-41015RR (8) 17-5-41015RR (9) 17-5-41015RR (10)
r-
17-5-41015RR (11) 17-5-41015RR (12) 17-5-41015RR (13) 17-541015RR (14) 17-5-41015RR (15)
17-5-41015RR (16) 17-541015RR (17) 17-541015RR (18) 17-5-41015RR (19) 17-5-41015RR (20)
17-5-41015RR (21) 17-541015RR (22)