HomeMy WebLinkAboutOP RHTE# Harnett County Department of Public Health 23282
PERMIT # �DD Operation Permit
New Installation D< Septic Tank Nitrification Line El Repair El Expansion
PROPERTY LOCATION. v )��
Name: (owner) IJ-r- SUBDIVISION LOT #
System Installer: &y v Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms
Type of Water Supply: ❑ Community 'X Public ❑ Well Distance from well feet
System Type: - aMo 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.
PERMIT CONDITIONS:
1. 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 ❑ Na
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑
h d
PWR Line
Following are the specifications for the sewage disposal system on t e a�ve captione proper
Type of system: ❑ Conventional Other Qy Pie �� �'0 Septic Tank: k500 gallons Pump Tank: gallons
Subsurface No of , exact length 1 kX width of depth of
Drainage Field ditches of each ditch 5 feet ditches 'c3 feet ditches inches
French Drain Required: feet
Authorized State Agent 111�� i4 -S) Date
13- j�3a5�„�sL