OPATE # 15 — 5-- 5Zq 5- Harnett County Department of Public Health 2 3 3 M
PERMIT # Z'% 7 ! Z —/ Operation Permit
Id New Installation C2" Septic Tank 2 Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: 07
Name: (owner) SUBDIVISION t/ oo AS LOT # 176
System Installer: Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms 3
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: AM 1Z0 ;�skg ica�'!ii' G dWr-- q— 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
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
with applicable North larolma heneral )tatutes, 8ules for )ewage treatment and Ulsposal, and all conmtlons or the
12
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 conditions, maintenance and reporting.
rermtt and Lonstrucnan Aumorrzanon.
/2r.
Z
1 S
❑
D -Box ❑
Pump ❑ Alarm
❑ H2OLine ❑ PWR Line
Following are the specifications
for the sew disposal
system on the above captioned property.
Type of system: El
Conventional Other
Z0b -PAtAv LKIAri—
Septic Tank: /10 0 gallons Pump Tank: gallons
Subsurface
No. of
exact length
width of depth of
Drainage Field
ditches
of each ditch Y ° feet
ditches 3 feet ditches f o inches
French Drain Required:
Linear feet
Authorized State Andtl- '� 1::::�-- Date (0, • Z.V- —a-1
13 -5- 32445(2)
13 -5 -32445 (3)
13 -5 -32445 (4)
13 -5 -32445 (5)
13 -5 -32445 (6)
13 -5 -32445 (7)
13 -5 -32445 (1)
13 -5 -32445 (8)
13 -5 -32445 (9)
13 -5 -32445 (10)
13 -5 -32445 (11)