OP RHTE #�3 �--13�� Harnett County Department of Public Health 23545
PERMIT # �'Operation Permit
New Installation '9� Septic TankX Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: ! Qjc- Y-�)
�-� Uc - SUBDIVISION LOT # CC
Name: (owner)
��� _—
System Installer: Registration #LJBasement with plumbing: El Garage X Number of Bedrooms
feet
Type of Water Supply: EJ Community � Public El Well Distance from well Typeand VI Systems expire in 5 years.
System Type:
(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.
K CN Lai ,j {Z,p
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:
Alarm ❑
PWR Line
H2OLine ElF]D-Box
❑
Pum El
p
Following are the specifications
for the sewage
disposal s stem on the above captioned property. Septic Tank: 1000
[[___
gallons Pump Tank: �od� gallons
Type of system: ❑
Conventional Other
exact length width of 3
depth of
1y inches
Subsurface
No. of
3
of each ditch 100 feet ditches
feet ditches
Drainage field
ditches
french Drain Re��ti
Date `�-
Authorized State
i3- 5-313-7a�
b