IPACHTE# 1 5-~ Harnett County Department Public Health
26977
r ve ent Permit
Authorized State Agent:: Date: 3 O 1 12. SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance r permits. The permit holder is responsibe for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation if the site plan, plat, or the intended use changes. The Improvement it shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .1950, .1952, .1954, .1955, .1956, .1951, .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall be installed in accordance
with the attached system layout.
ISSUED TO: cc.~'otL V_I-I dfZ,?s(- G PROPERTY LOCATION: OSIX*P, QP
SUBDIVISION LOT #
Facility Type: C~c= CS rv t~ S"Zat~~ New ❑ Expansion ❑ Repair
Basement? ❑ Yes No Basement Fixtures? ❑ Yes XNo
Type of Wastewater System**~1 no V1~~ Sys (Initial) Wastewater Flow: L®o GPD
(See note below, if applicable
~-5tll ~ 'Es~~ Cr'- .N C) r,f (Repair)
Installation Requirements/Conditions Number of trenches 1
Septic Tank Size 1 o b 0 gallons Exact length of each trench SO feet Trench Spacing: ! Feet on Center
Pump Tank Size gallons Trenches shall be installed on contour at a Soil Cover:(1 _ inches
Maximum Trench Depth of: 11-_50 inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM inches below pipe
Aggregate Depth: inches above pipe
Conditions: inches total
LINES (I" "r"13 IRRIGATION) MIST RE I OFT. FROM ANY PART F SEPTIC SYSTEM OR REPAIR AREA.
UOt'ITIES L J I INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: I understand the system type specified is different from the type specified on the application. / accept the specifIcations of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is sub-Je!rTQ; anon if the r% Ian, plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authmization"I psi ct\o compliant ith the o e Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: > \ » Date:
Cons n Authorization Expiration Date:
HTE#
Permit #
Department of Environment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: Design Flow (.1949): i 0 d~
Location of Site: Property Recorded:
Water Supply: I Public❑ Individual ❑ Well
Evaluation Method: [~Au erBoring ❑ Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot
File
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
I J
I 9 40
OIL MORPHOLOGY
.1941
THER
PROFILE FACTORS
L
E
#
~
andscape
Position/
Slope %
ci-~°Jc
Horizon
Depth
(hi.)
0 b
.1941 .1941
Structure/ Consistence
Texture Mineralogy
`fi't "~1
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944 Profile
Restr Class
Horiz & LTAR
5 Gt
0 - r--)L-;~-
Description
Initial
S ste
Re air System
Other Factors (.1946):
Site Classification (.1948): S
Available Space (.1945)
Evaluated By:
System T e(s)
to
Others Present:
Site LTAR
C