OPHTE# 13 -�r -3r88Z Harnett County Department of Public Health
PERMIT # 27=6'7 / Operation Permit 22989
D NeW Installation Septic Tank 2 Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: _'5/Z Ili 18 0441) ally- 9 ( �
Name: (owner) S%l SUBDIVISION LOT # J4
System Installer: ' /4tnmeg zl Registration #
Basement with plumbing: ❑ Garage ❑ flumber of Bedrooms 3
Type of Water Supply: ❑ Community E�' Public ❑ Well Distance from well feet
System Type: Zs'Ol6 RI csz ✓�- - 5�s,f�— GAR7, c TypesJ and VI Systems expir \n 5 years.
(In accordance with Table V a) y hr must contact Health Department b months p or to expiration for permit renewal.
This system has been installed in compliance with appl able North Carolina General Statutes, Rules for
t1:511/-
Treatment and Disoosal, and all conditions of
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Permit and Construction Authorization.
PERMIT CONDITIONS:
1. Performance: System shall perform in accordance with Rule .1961. At 141 8 D4 KJUt >&. (-' ZTVQ-ti tLAf-_�>
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 ❑
Pump ❑ Alarm
❑ H2OLine ❑ PWR Line
Following are the specifications for the sewa$e disposal
system on the above captioned property.
Type of system:
❑ Conventional 2 Other
Septic Tank: ID 0 gallons Pump Tank: gallons
Subsurface
No. of
exact length
width of depth of
Drainage Field
ditches
of each ditch ! ao feet
ditches 3 feet ditches` _ inches
French Drain Required: Linear feet
Authorized State Ag Date '3
13 -5 -31882 (1)
13 -5 -31882 (2)
13 -5 -31882 (3)
13 -5 -31882 (4)
13 -5 -31882 (5)
13 -5 -31882 (6)
13 -5 -31882 (11)
13 -5 -31882 (7)
13 -5 -31882 (8)
13 -5 -31882 (9)
13 -5 -31882 (10)