OPHTE# 1'3 Harnett County Department of Public Health
PERMIT # Z�S �� Operation Permit 22998
EKNew Installation 12" Septic Tank C- Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: ator
Name: (owner) A-,-,.r., .T-,uc. SUBDIVISION L7-4r3&,,_ - LOT # 9�7
System Installer: L n - - Registration #
Basement with plumbing: El Garage umber of Bedrooms
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: ZS�Ia tZe- 0 -Zrzd-)_ T-� (-x F�T- Types V and VI S ems - expire in 5 years.
(In accordance with Table V a) Owner must epartment 6 month prior to expiration for permit renewal.
This system has been installed in compliance with applicable Noith Carolina General Statutes, Rules for Sewa¢e Treatment and Disposal, and all conditiins of the Improvement Permit and Construction Authorization.
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PERMIT CONDITIONS:
1. Performance: System shall perform in accordance with Rule .1961.
11. 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 ❑
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: El Conventional D /Other ZS _"I& )Z'rbucizrn, Septic Tank: t y v v
Subsurface No. of exact length width of
Drainage Field ditches 3 of each ditch J t7v feet ditches 3
French Drain Required: Linear feet
H2OLine ❑ PWR Line
gallons Pump Tank: gallons
depth of
feet ditches 7 N ) I S inches
Authorized State AQe ,,� Date
fo -36 -I.
13 -5 -31950 (1) 13 -5 -31950 (2) 13 -5 -31950 (3) 13 -5 -31950 (4) 13 -5 -31950 (5)
13 -5 -31950 (6) 13 -5 -31950 (7) 13 -5 -31950 (8)