OPHTE#_/,�_- 5-�.*.k>cZ 18 Harnett County Department of Public Health 23697
PERMIT # c2i,4 c? Operation Permit
2 New Installation LTJ Septic Tank -� Nitrification line ❑ Repair ❑ Expansion
PROPERTY LOCATION: /1;�r4l�f-
Name: (owner) �;, e� C,,rr ` SUBDIVISION Gee r Qx);e l i LOT # -Z
System Installer: 1 g a e_ Registration #
Basement with plumbing: ❑ Number of Bedrooms
Type of Water Supply: ❑ Community [?'I ubJjc El Well Distance from well 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.
Ihis 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
s
MN
�Ilf 144
rt:ninn tutvunw111:
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 ❑ PWR Line
Following are the specifications for the sewa Isposal ss stem on a above captioned property.
Type of system: El Conventional Other (� .� �c. Septic Tank:/00 Ci gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches _„�3 of each ditch %O U feet ditches —3 feet ditches / '-�W inches
French Drain Required: Linear feet
Authorized State Age ./'<,,..— ,.._.. � t, 74,+„, _ !l� � Date 7 / / 0
lr-J; -7 (, 218