HomeMy WebLinkAboutOPHTE# /3 -s=,,7f (-xt Harnett County Department of Public Health
PERMIT # 9-7gi2— Operation Permit 22963
New Installation E�—Septic Tank R2"/- Nitrification Line ❑ Repair ❑ Expansior
PROPERTY LOCATION: Cve r-;rf-Xd
Name: (owner) ���� %ta� T v,�.w�r �y SUBDIVISION k L� :- LOT #
System Installer: G •`f ki . d Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms 3
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: %!� 9 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.
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
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I. Performance: _ System shall perform in accordance with Rule .1961.
II. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No Wr
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
❑ D -Box ❑ Pump ❑ Alarm ❑ 1-12O1-ine ❑ PWR Line
Following are the specifications for the sews disposal system on the above captioned property.
Type of system: El entiona t' Convl l Other 97—r j Septic Tank: / 6 C° U gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches Ck of each ditch 7�— feet ditches —3 feet ditches 30'ZV inches
French Drain Required: Linear feet /-17 /XC Authorized State Agent tea:-- l Date /1' 1 %
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