HomeMy WebLinkAboutOPHTE# �� -s =� �� Harnett County Department of Public Health 23252
PERMIT # a y% 0 eratI on Permit
2 New Installation 2Se tic Tank P�Nitrification Line ❑ Repair ❑ Expansion
"� PROPERTY LOCATION: �>s «�
Name: (owner) �r- 3e���, ft�.«�¢/ SUBDIVISION LOT #
System Installer: 044"'c Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms _$_
Type of Water Supply: ❑ Community EiAblic ❑ Well Distance from well feet
System Type: -,5T— 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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PERMIT CONDITIONS:
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 Ef-
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 sewa disposal system on the above captioned property.
Type of system: ❑ Conventional Other 2oc /ate Septic Tank: c� �G gallons Pump Tank: gallons
Subsurface No. of _ exact length width of depth of
Drainage Field ditches S of each ditch oU feet ditches �_ feet ditches l8- inches
French Drain Required: Linear feet
Authorized State Agen ��� Date
1,3 S- 3z S'C?