OPHTE #� 3os��i Harnett County Department of Public Health
PERMIT # �-`� �-��- Operation Permit 22863
New Installation X Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: 00C,5
Name: (owner) Y`0 e_ .E.C_ A0 m y—LS SUBDIVISION xT-- _LOT # 14a
System Installer: C—,..c:> o ) E Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms
Type of Water Supply: El Community A Public ❑ Well Distance from well l (bO feet
System Type: 1 Lc 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.
finis system nas oeen mstauea in compuance wim appncame norm Lamina uenerai statutes, naves tar sewage ireatment ana otsposat, ana an conatttons of the improvement rermit and Lonstruction Authorization.
0bo
s
4 $1
PtRMII LONDIIIUNS:
I. Performance: System shall perform in accordance with Rule .1961.
II. Monitoring: As required by Rule .1961.
111. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No
If yes, see attached sheet for additional operation ct
IV. Operation:
V. Other:
1`l U DS6
maintenance and reporting.
❑
D -Box
❑ Pump ❑ Alarm ❑
H2OLine ❑ PWR Line
Following are the specifications
for
the sewage disposal s stem on the above ja ttone roperty.
Type of system: El
Conventional
Other �A;-' �� Septic Tank:160 d
gallons Pump Tank: gallons
Subsurface
No. of,
exact length width of
depth of
Drainage Field
ditches
of each ditch add feet ditches -2.1
feet ditches inches
French Drain Reauired:
Authorized State Agent "4 a�)_S Date S 1 »'i T 3