OP -TANK FOR BEAUTY SHOPHTE# /0 s'= 0a.(- "-'— Harnett County Department of Public Health
2311
PERMIT # x—_7767 Operation Permit
ZNew Installation E? Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: Cy,o�yl �iE ems.
Name: (owner) f -rr-,l SUBDIVISION _C�4rtfj LOT # y
System Installer: 4.cs, to a Registration #
Basement with plumbing: ❑ arage ❑ umber of Bedrooms S
Type of Water Supply: ❑ Community EP" Public ❑ Well Distance from well feet
System Type: iff --G" 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.
This 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
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I. 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 ❑ H2OLine ❑
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional C Other CZ it Septic Tank: / gallons Pump Tank: _
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch % y feet ditches feet ditches E8
French Drain Required: Linear feet
Authorized State Agen I� I / L,-( /e e% Date Y/' 7 moo/ /
PWR Line
gallons
inches
l3 -r -.72 b 6- —