OPHTE# o - a I Q~13 Harnett County Department of Public Health 2 0 5 7 2
PERMIT # -P--YI Operation Permit
Name: (owner) I t r'-'-~ ~C- a r
System Installer. .C~ c>(s,
Basement with plumbing: ❑ Garage Z Numbe
Type of Water Su ply: ❑ Community 32- Public
System Type: c~
(In accordance with Ta le V a)
New Installation fie is Tank ❑ Repair- X Nitrification Line ❑ Expansion
PROPERTY LOCATION- v
SUBDIVISION fti vy~ /I LOT # -2 6
Registration #
r of Bedrooms - 3
Well Distance from well feet
Types V and VI Systems expire in 5 years.
Owner must contact Health Department 6 months prior to expiration for permit renewal.
ibis 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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MMIT rALMITIAM
I. 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 ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
Following are the specifications for the sewage disposa~system on the above captioned property.
Type of system: El Conventional 7 Other ~j , (,7 ( 14 Septic Tank: gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch 0 ) feet ditches feet ditches inches
French Drain Required: Linear feet
Authorized State Agent
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