OP�TE# lla—S�31531 harnett County Department of Public Health J
PERMIT # 15'3 Operation Permit
XNew Installation, Septic Tank X Nitrification Line ❑ Repair ❑ Expansion
} , PROPERTY LO(ATION:
Name: (owner) -A a v-- t—toQ,S a zv SUBDIVISION LOT #
System Installer: Ns®,,� `A A-y,� 1��t Registration #
Basement with plumbing: ❑ Garage %% Number of Bedrooms
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well t Od feet
System Type: c) 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.
tms system has been installed in
PERMIT CONDITIONS-
with applicable north Larollna General Statutes, rules for Sewage treatment and Disposal, and all conditions of the Improvement Permit and Lonstructlon Authorization.
M
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 x
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 sewage disposal system on the above captioned property.
Type of system: ❑ Conventional Other s -1`hr Septic Tank: 1 0C) C1 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field --- &tcUs 3 of each ditch feet ditches '73 feet ditches ,� inches
French Drain Reauired: L>iaear feet
Authorized State Agent e-filk5 Date tt