OPHTE #I ! S— -`-' -7Harnett County Department of Public Health
23606
PERMIT # 1 -7 Operation Permit
ILS New Installation Er Septic Tank Z Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:rwLls-� c. c64A 9-0
Name: (owner) 9e— ,�„�.�. tc�J SUBDIVISION LOT #
System Installer: Ke" ,,ra�-- (�. = Registration #
Basement with plumbing: ❑ Garage ❑ 1A,mber of Bedrooms 3
Type of Water Supply: ❑ Community IJ Public ❑ Well Distance from well feet
System Type: t -s`5% ;5-jrt--- n;i" 6- r-"2 C.4aTypes 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 cor*liance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
rtNMll LUNullIUNS:
I. Performance:
System shall perform in accordance with Rule .1961.
II. Monitoring:
As required by Rule .1961.
111. 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 ❑
H2O1-ine ❑ PWR Line
Following are the specifications
for the sewa a disposal system on the above captioned property.
2 5 Om n, --Z) J
Type of system: ❑
Conventional Other &f-zla... ��� F n Septic Tank: 1&0
gallons Pump Tank: gallons
Subsurface
No. of exact length width of
depth of
Drainage Field
ditches of each ditch 8 c> feet ditches
feet ditches 2 q inches
French Drain Required:
Linear feet
Authorized State Age - y�,� _ _' Date & -i 18
15-5-35922 (1) 15-5-35922 (2) 15-5-35922 (3) 15-5-35922 (4) 15-5-35922 (5)
15-5-35922 (6)