OP RHTE# - 2&1C6-/Z Harnett County Department of Public Health
PERMIT #Operation Pe fmlt 2 2 0 9 3
New Installation L/ Septic Tank /Nitrification Line ❑ Renair FI Fxnansinn
Name: (owner)
System Installer: a .
Basement with plumbing: ❑ Garage V public of Bedroom
Type of Water Supply: ❑ Community Lf1 Public ❑ Well
System Type: , a Z, 4rL)) yL4,L._
:Jtys
(In accordance with Table V a)
PROPERTY LOCATION:
~~c.. ~r
SUBDIVISION LOT #
Registration #
Distance from well feet
C- aZ-U2 Types V and VI Syste expire in 5 years.
Owner must c tact Health Depart 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatmen nd Disposal, and all conditions of the Improvement Permit and Construction Authorization.
a
PERMIT CONDITI :
L Performance: System shall perform in accordance with Rule .1961. 112
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 conditions, maintenance and reporting.
IV. Operation:
V. Other:
❑
D-Box ❑
Pump ❑ Alarm
❑ H20Line ❑ PWR Line
Following are the speci
fications for the sews
disposal system on the above captioned property.
Type of system: ❑
Conventional EO
ther 1;,j'Z 4.--
Septic Tank: 1 `Lpi> gallons Pump Tank: gallons
Subsurface
No. of
exact length
width of depth of t
3
Drainage Field
ditches
of each ditch fcaU feet
ditches
feet ditches inches
French Drain Required:
Linear feet
Authorized State 4
Date Z' 2