REPAIR OPHTE #
PERMIT # Z8901
Name: (owner) (A) N�
System Installer:
Basement with plumbing: ❑
Type of Water Supply: ❑ Co
System Type: Z� 6 f.1•ti7UC
(In accordance with Table V a)
This system has been installed in
Harnett County Department of Public Health 23346
Operation Permit
C' New Install tion Septic Tank Z Nitrification Lin C- Repair L Expansion
PROPERn LOCATION
s SUBDIV SION LOT #
�f
Registration #
Garage ❑ umber of Bedrooms
nity Public ❑ Well Dist ce fro well feet
i� Types V and VI Systems expire in 5 years.
wner t cont t Health Department 6 months prior to expiration for permit renewal.
with applicable North Carolina Ge eral St tutes, Rule for Sewage tatment and Disposal, and all conditions of the
14
1 ti
t
5P 1 - .
PERMIT CONDITIONS:
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 ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
Permit and Construction Authorization.
❑
D -Box ❑
Pump ❑
Alarm ❑ 1-12O1-ine ❑ PWR Line
Following are the specifications
for the sewage disposal system on the above captioned property.
Type of system: ❑
Conventional C?' Other
?S °/s
Septic Tank: gallons Pump Tank: gallons
Subsurface
No. of
exact length
width of depth of
Drainage Field
ditches _
of each ditch 8o feet
ditches 3 feet ditches inches
French Drain Required:
Linear feet
Authorized State Age —� --�' may,., t �r �, Date ,, —1 `1-Z `j
Nelson Austin Repair 8 -19 -14 Nelson Austin Repair 8 -19 -14 Nelson Austin Repair 8 -19 -14 Nelson Austin Repair 8 -19 -14 Nelson Austin Repair 8 -19 -14
Nelson Austin Repair 8 -19 -14 Nelson Austin Repair 8 -19 -14 Nelson Austin Repair 8 -19 -14 Belson Austin Repair 8 -19 -14 ( Nelson Austin Repair 8 -19 -14