OPHTE# /,3'S-3<15 Harnett County Department of Public Health
PERMIT # a-7 y )-y Operation Permit 22933
C'New Installation 21' -Septic Tank R"-Nitrification Line ❑ Repair ❑ Expansion
/ PROPERTY LOCATION:
Name: (owner) % C /«r` /�o.�ei SUBDIVISION C LOT # 1QY
System Installer: 07 —"Lef Registration #
Basement with plumbing: El Garage' El Number of Bedrooms Y
Type of Water Supply: ❑ Community 2'—Public ❑ Well Distance from well feet
System Type: ILL G 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
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PERMIT CONDITIONS:
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:
❑
D -Box ❑
Following are the specifications for the
Type of system: ❑
Conventional
Subsurface
No. of
Drainage Field
ditches
Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
sew,W disposal system on the aboKe captioned property.
U Other Q v: c %' C Septic Tank: /(300 gallons Pump Tank: gallons
exact length width of depth of
of each ditch f -y feet ditches 3 feet ditches /8-2-(3 inches
French Drain Required: Linear feet
C
Authorized State Age w— . E Date
1 _7,5— 3 o 7 5—q