OPHarnett County Department of Public Health J
PERMIT # Q-7 tor-y Operation Permit
I New Installation 'N Septic Tank V Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: �S au -,Pf -rL D z,
Name: (owner) C, w tir,%G SUBDIVISION \-� E5-1 \n C Q`INL u mm. N LOT # 1-1
System Installer: 2'-Q ® (:� s> tLc-iU2 - Registration #
Basement with plumbing: ❑ Garage XNumber of Bedrooms
Type of Water Supply: ❑ Community Public ❑ Well Distance from well t b C7 feet
System Type: 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.
Ihis 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
rtKMI I IUNUII IUNS:
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 ❑ N.
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 abo a cap .� ed property.
Type of system: ❑ Conventional VOther Cta;>.sr,6 Septic Tank: Ind
Subsurface No. of exact length width of
Drainage Field ditches \ _ of each ditch t cli 0 feet ditches 3
French Drain Reauired: c� . \iae�xfeet
H2OLine ❑ PWR Line
gallons Pump Tank: gallons
depth of
feet ditches 4—ao inches
Authorized State Agent__ �� ,���\�`� &)5 Date Iii V\
Zf�
f P t
ht u's
�
i
t
C
a13VL -nom ®a a
rtKMI I IUNUII IUNS:
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 ❑ N.
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 abo a cap .� ed property.
Type of system: ❑ Conventional VOther Cta;>.sr,6 Septic Tank: Ind
Subsurface No. of exact length width of
Drainage Field ditches \ _ of each ditch t cli 0 feet ditches 3
French Drain Reauired: c� . \iae�xfeet
H2OLine ❑ PWR Line
gallons Pump Tank: gallons
depth of
feet ditches 4—ao inches
Authorized State Agent__ �� ,���\�`� &)5 Date Iii V\