OPHTE#,/ --2-/&V 3 Harnett County Department of Public Health
PERMIT #26.,35 Operation Permit 2 2 0 9 7
2/ New Installation Ei Septic Tank M'O" Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: 1~uoz r
Name: (owner) a Al, SUBDIVISION rc~ ~1 LOT #
System Installer: *
Iec C Registration #
Basement with plumbing: ❑ Garage' umber of Bedrooms ...3
Type of Water Supply: ❑ Community 2". V umber
❑ Well Distance from well cWa ?<'eet
System Type: 6 2tiw i2 =N-14t1 5&,sf t`1 ypes 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
NtRPIII LUNUIIIUM:
1. Performance:
II. Monitoring:
111. Maintenance:
IV. Operation:
V. Other:
System shall perform in accordance with Rule .1961. e F~
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-Box ❑ Pump ❑ Alarm ❑ H20Line ❑ PWR Line
Following are the specifications for the sews disposal system on the above captioned property
Type of system: ❑ Conventional Other ¢v ~Septic Tank: 1000 gallons Pump Tank: i 0 0 ~ gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 3 of each ditch a feet ditches 3 feet ditches 2-4 inches
French Drain Required: Linear feet
Authorized State Ag nt Date L-L_1 -17-
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11-5-27643(1)
11-5-27643(2)
11-5-27643(3)
1 -_-27643(4)
11-5-27643(5)
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11-5-27643 (6)
11-5-27643 (7)
11-5-27643 (8)
11-5-27643 (9)
11-5-27643 (10)
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11-5-27643(11)
11-5-27643(12)
11-5-27643(13)
11-5-27643(14)
11-5-27643(15)
11-5-27643 (16)
11-5-27643 (17)