OPHTE# /J"�` ��y72 Harnett County Department of Public Health 23085
PERMIT # 60 Operation Perm —it
C New Installation 10" peptic Tank Rr Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: 1 )—,j
Name: (owner) ; C cs.,r SUBDIVISION C a kr LOT # o99
System Installer: Ta 4 vJ 'f& c Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms J'
Type of Water Supply: ❑ Community 26ublic ❑ Well Distance from well feet
System Type: 2ZC (:—� 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.
mis system nas peen mstauea in compuance wan appncame Norm tarolma ueneral Statutes, Rules for Sewage Ireatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
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NtKMII LUNUIIIUNS:
1. 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 ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional Other (�u:c, k I/ ('—'A' M 4e^ Septic Tank: gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches ( of each ditch feet ditches feet ditches q inches
French Drain Required: Linear feet
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Authorized State Agen �� — w w -- ,.�C /�%� Date % 4, a26 /Y
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