HomeMy WebLinkAboutOPHTE# j - _2_ arnett County Department of Public Health 2 3 i 8 7
PERMIT # 7 Operation Pier it
L� New Installation L1 Septic Tank Imo" Nitrification Line ❑ Repair ❑ Expansion
Name: (owner) S PROPERTY LOCATIO 76
_ - (VISION
/, c C °..,sues, " LOT # J
System Installer: Registration #
Basement with plumbing: ❑ Garage ;)Public mber Bedrooms Type of Water Supply: El Community ❑ Well Distance from well feet
System Type: _ tS 'Os'z r'ZC—J) ZZ& Types V and VI Systems expire in 5 years.
(In accordance with Table V a) 6wner 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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PERMIT CONDITIONS: U
I. Performance: System shat perform in accordance wi h Ru .1961.
II. Monitoring: As required by Rule .1961.
III. 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 ❑ H2OLine ❑ PWR Line
Following are the specifications for the sews disposals stem on the above captioned prop,
Type of system: ❑ Conventional Other / 11�()Z t �'i'� Septic Tank: gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch U feet ditches feet ditches inches
French Drain Required: Linear feet
Authorized State Ag nt Date ..- � f