OP RHTE# j ' s L)O - j /3 R Harnett County Department of Public Health 2 0 6 3 9
PERMIT # Operation Permit
tg- flew Installation ;4-Septic Tank ❑ RepairrZ. Nitrification Line ❑ Expansion
PROPERTY LOCATION: la 7
Name: (owner) 5AAL-41 SUBDIVISION - LOT #
System Installer. M , hr 4'^3 Registration # a 7
Basement with plumbing: ❑ Garage D Number of Bedrooms 3
Type of Water Supply: ❑ Community ❑ Public JZ Well Distance from well 'J feet L4 e l/ N-"~ t t f t ` ' 3-j Y-0 7
System Type: GQ TM ~ 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.
t
cr
r
-r
C
l~
1. Performance:
II. Monitoring:
111. Maintenance:
IV. Operation:
V. Other.
System shall perform 0 acc" ce with Rule .1961.
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.
Following are the specifications for the sewage disposal stem on the above captioned property.
Type of system: ❑ Conventional V Other ~ M -T_ Z( 2,/( Septic Tank: gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage field ditches of each ditch feet ditches 3 feet ditches inches
French Drain Required: Linear feet
Authorized State Agent Date
nn> >pmm nea ueeu maaueu in compliance wim appucame north carouna beneral Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
~y
y
~
1
PFRMIT fnNDITInNt- i
(J~r
~
Fa
Y ~
T ~ ft
~
s
d ~
r
mill I
w
li~et
i
3
r
3.. '~"~=rrr~y~
_
s