OPHTE# 0--G7- z5 Y95 Harnett County Department of Public Health
PERMIT # Operation PPeroit 21 7 2 8
New Installation 9 Septic Tank Q' Nitrification Line ❑ Repair El Expansion
PROPERTY LOCATION:
Name: (owner) TAS t /Z SUBDIVISION LOT #
System Installer: C /;,.4 1- Registration #
Basement with plumbing: ❑ Garage 21,~Number of Bedrooms 3
Type of Water Supply: El Community E2,/Public Well Distance from well feet ,Vl System Type: 117 C pes V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must contact ealth Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Dis6pl, and all conditions of the Improvement Permit and Construction Authorization
rtmmi t.unutiiurix
1. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
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
❑ 1-1201-ine ❑ PWR Line
Following are th
e specifications for the sews disposal system on the above captioned prope ty.
"
Type of system:
El Conventional
S (4
19 Other 25 lt~l;)(3
Septic Tank: 10 gallons Pump Tank: gallons
Subsurface
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ld
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exact length
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width of depth of
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es
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feet
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French Drain Required: Linear feet
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