OP RRharnett County Department , Public
PERMIT # `��-��1 Operation Permit
New Installation Septic Tank ;�( Nitrification Line ❑ Repair ❑ Expansior
PROPERTY LOCATION:
Name: (owner) ata -C.-3, \At,% UBDIVISION LOT # _
System Installer: Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms 3
Type of Water Supply: ❑ Community '� Public ❑ Well Distance from well ` ®D feet
System Type: 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.
ims system nas oeen instauea in compliance wan appucaole north larolma beneral )tatutes, Nules for )ewage treatment and
and all conditions of the Improvement Permit and Construction Authorization.
tS14'
PtRMII LUNVIIIONS:
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:
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional Other ` —2-- V1-01vJ Septic Tank: Je)(Z) % gallons Pump Tank:
Subsurface No. of exact length width of depth of
Drainage Field tches of each ditch ®® feet ditches feet ditches
French Drain Required: ti -Linear feet
Authorized State Agent��_ \\�� nS Date
PWR Line
gallons
inches
) ) - 5 - �,QO Q -Q,