OPHTE# ~ 1-5- Harnett County Department of Public Health
PERMIT # b~ Operation Permit 2 2 2 0 8
New Installation Septic Tank W Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: f~xS 9tp
Name: (owner) Howoctfl ~vti~rJEct~S SUBDIVISION ~S~~GFaQ~J -LOT # 15
System Installer: i ^~r+rJ Registration #
Basement with plumbing: ❑ Garage X Number of Bedrooms
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 10 CJ feet
System Type: cn 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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FERrnt Wtruttwtrs:
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 ❑ NOX
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
❑ D-Box ❑ Pump ❑ Alarm ❑ H20Line ❑ PWR Line
following are the specifications for the sewage disposal system on the above ca2tioned property.
Type of system: ❑ Conventional Other CIAKP 67 Septic Tank: 40ZQ gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches- 1 of each ditch t 50 feet ditches 3 feet ditches aA-A inches
French Drain Required: ~~Kiiaear feet
Authorized State Agent -v Date
-77
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