HomeMy WebLinkAboutOP RHTE# i :5-q 1166t Harnett County Department of Public Health 24700
PERMIT # 'Z 0 eration Permit---� /
CRL4 ew Installation Septic Tank ,1d-Nltrfflcation Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: I-II Ln . (tvc Q I ci u-)
Name: (owner) G i SUBDIVISION 13'61^ 1\-%C- A LOT # �<l-
System Installer. Ra. / CS cvA N� <- Registration #
Basement with plumbing: ❑ Garage umber of Bedrooms 3
Type of Water Supply: ❑ Community El -f0 —ic ❑ Well Distance from well /\J4 feet
System Type: ZS% -1�� s0 n 5;2s , 772M 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.
skis 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
PERMIT CONDITIONS
I. Performance:
ll. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
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System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
❑ D -Boz ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
following are the specifications for the sewage disposal system on the above caaptio�nedd Property.
Type of system: El Conventional 9 l��
r 4 GYswsl.,� J.1.LY� Septic Tank: t CXX7 gallons Pump Tank: 1001S gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches I of each ditch 3og feet ditches 3 feet ditches 8 inches
French Drain Required: Linear feet
Authorized State Agent Date a a ( acs 1 a0142>
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