OP R - chg'd lot # to reflect Lot 7 Cinnamon Hill- originally issued as Lot 2HTE# 06 soO -- ;b; ?b(I Harnett County Department of Public Health 20741
PERMIT # Operation Permit is
4W--&w Installation�eptic Tank ❑ Repa� Nitrification line ❑ Expansion
PROPERTY LOCATION: L..t.R� < <
Name: (owner) �v; j A iz SUBDIVISION �ZS " j,1jAA A0 LOT #
System Installer: Registration # 111rin ell "'0
Basement with Plumbing: ❑ Garage -0—'Number of Bedrooms
Type of Water pply: ❑ Community Public ❑ Well Distance from well 3 J feet
System Type: s �„�` ly,�jcr �( u Types V and VI Systems expire in 5 years.
(In accordance with Tab e Y a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with a
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(A A-W-
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1. Performance:
II. Monitoring:
III. Maintenance:
IY. Operation:
Y. Other.
i�
North Carolina Gene* t , Rules for �Ve it ent an Di posat aR co ors of rove
y���d - j adt� !rd� dL-jmP m4tH Permit and Coiswction dusheri:arinn. —�,
1.6.
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No
If yes, see attached sheet for additional operation
Ova
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maintenance and reporting,
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following are the specifications for the sewa a disposal sys the above capti ned proper / \t
Type of system: ❑ Conventional Other Wry Al �` L Septic Tank �� � ga ►Ions Pump Tank: `�� C) gallons
Subsurface No. of exact length width of g
depth of
Drainage field ditches of each ditch `�� feet ditches` feet ditches_ inches
french Drain Required: linear feet
Authorized State Agent ( 1 �_ ) f & t) Date — 1 2 tom%
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