OPHTE#_/!;--s--53n32 Harnett County Department of Public Health 236E
PERMIT # MZz3 ODeration Permit ��
New Installation �ptic Tank L�Nitrification Line ❑ Repair ❑ Expansion
PROPER ATION: �r ,� g,0���
Name: (owner) ) 4— SUBDIVISION LOT #
System Installer: Registration #
Basement with plumbing: ❑ Garage mber of Bedrooms 3
Type of Water Supply: ❑ Community Public ❑ Wek Distance from well feet
T" r G
System Type: 1a.•� '�'�- i ` /; and VI Systems expire in ears:
(In accordance with Table V a)wner must contact Heal Department 6 months prior to expi
This system has been installed in compliance with apable North Caroli\6e\nl ` es, Rules for Sewage ree and Disposal, and all conditions of the Improve
PERMIT CONDITIONS:
1. Performance:
11. Monitoring:
111. Maintenance:
IV. Operation:
V
1
System shall perform in accordance with Rule .1961.'1 7`
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.
for permit renewal.
Per%anonstruction Authorization.
V. Other:
❑
D -Bax ❑
Pump ❑ Alarm ❑
H2OLine ❑ PWR Line
Following are the specifications for the sdisposal system on the above captioned property.
ewa
Type of system:
El Conventional
Other °!ffi /u �+� - Septic Tank: ° ° c'
gallons Pump Tank: gallons
Subsurface
No. of
exact length width of
depth of
Drainage Field
ditches `"I
of each ditch 6p feet ditches
feet ditches I Z—>d e inches
French Drain Required: Linear feet
Authorized State A Date — "
15-5-35432 (1)
15-5-35432 (2)
15-5-35432 (3)
15-5-35432 (4)
15-5-35432 (5)
15-5-35432 (6)
15-5-35432 (7)
15-5-35432 (8)
15-5-35432 (9)
15-5-35432 (10)