OPHTE#Ze S`- Z5-~? Harnett County Department of Public Health
PERMIT # ZC-YO?- Operation PPer~it 2 2 0 5 8
Id New Installation l~l SeRtic Tank Z Nitrification Line ❑ Repair ❑ Exaansion
PROPERTY LOCATION: IY3I 8 v, /z0
Name: (owner) 5ir'i lte~ SUBDIVISION tN-Ae01- LOT # _
System Installer: 3Ji^,' ¢c.,. Registration #
Basement with plumbing: ❑ Garage Number of XWell ooms I
Type of Water Supply: ❑ Community ❑ Public Distance from well /6b'4' feet
System Type: 5Z- Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must con act Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North C lina General Sta tes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Instruction Authorization.
s
!5 hte4
.r i
i
E{ s a~
1.6
V
i C? G
q~3
A
j
V
79D
PERMIT CONDITIONS:
'5` '
- ~
I. Performance:
System shall perform in accordance with Rule .1961.
-
11. Monitoring:
As required by Rule .1961.
111. 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 seww5ge disposal system on the above caption
ed property.
Type of system: ❑
Conventional 1Z Other &Mf t," '
Septic Tank: i 7t:x 0 gallons Pump Tank: gallons
Subsurface
No. of exact length
2
0
width of
3
depth of
Drainage Field
0
ditches of each ditch
,
feet ditches
feet
ditches inches
French Drain Required: Linear feet
Authorized State Ag nt Date I I I
V Z9