OPHTE# 08 - 5-Zozz5` Harnett County Department of Public Health 2 0 4 4 2
PERMIT # /,'/8 / / Operation Pe it
1New Installation Septic Tank ❑ Repair Nitrification Line ❑ Expansion
PROPERTY LOCATION: 1f~~ u q2-
Name: (owner)cl SUBDIVISION LOT # ___I-_
System Installer: Registration #
Basement with plumbing O arage Number of Be ooms
Type of Water Supply: ❑ Community ❑ Public Li~ Well Distance from well / /
feet
System Type: ('arrive„ ~ 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.
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.
2501 12A-bocce~ lC~
~x~ X4,5
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PERMIT CONDITIONS
1. Performance:
II. Monitoring:
111. Maintenance:
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System shall perforn~l in 3ccordanc~ with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other.
IV. Operation:
V. Other:
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting
Following are the sp ifications for the sewage disposal system on the above captioned property.
Type of system: Conventional ❑ Other
Subsurface No. of exact length
Drainage Field ditches of each ditch 12 5 feet
French Drain Reauired: linear feet
Authorized State
Septic Tank: / 0 O gallons Pump Tank: gallons
width of depth of
ditches 3 feet ditches Z inches
Date q - t L - 0
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