HomeMy WebLinkAboutOPHTE# )--?" 5— H W3 Harnett County Department of Public Health 24605
PERMIT # a. Operation Permit
New Installation 1. Septic Tank '�< Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: �Po-f=P�1, D2
Name: (owner) WF c' J G2 l { or�Eh G n c SUBDIVISION -k t`rN-0 k j Cn.osS LNe LOT # E
System Installer: s» Srs.cc -Prep Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: �c Types V and VI Systems expire in S 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 compliana. 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'MiI LUNDIIIUNS:
1. Performance: System shall perform in accordance with Rule .1961.
11. 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 u
IV. Operation:
V. Other:
maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑
H201 -ins ❑
PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional Other E —4 fL.O'N Septic Tank: ICCZ gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch 4.00 feet ditches 3 feet ditches gk�t inches
French Drain Require Linear feet
Authorized State Agent Date 'I
�14
44'
40