OPHTE# 13 -s 3147 /Y- Harnett County Department of Public Health
PERMIT # a7 01 "i 2-- Operation Permit 22573
dNew Installation 0f Septic Tank Ea"'Nitrification Line ❑ Repair ❑ Expansion
//�� pp PROPERTY LOCATION:
Name: (owner) /!:n a fur• cell SUBDIVISION LOT #
System Installer: G tf I a T-ene % Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms oZ
Type of Water Supply: ❑ Community 0' Public ❑ Well Distance from well feet
System Type: Cr- 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.
rnis system nas peen mstanea in compoance wim appucame norm Lamina 'Jenerai uamtes, KUM for sewage ireatmem ana tnsposai, ana an conamons or me
r
i
4 J—y i f ear Coca % =�"I �.
�ge
W.rc,RJ
PERMIT CONDITIONS:
1. 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:
rerm¢ ana Lowman eumonzanon.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewa disposal -syste�m^- on the above captioned property.
Type of system: ❑ Conventional Other C 2-ir /CII-3 Septic Tank: 06 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch 7,S`— feet ditches > feet ditches 6' inches
French Drain Required: Linear feet
Authorized State Agen . ;. Date qLl
I3- .1 = ') a-�1I