OP RHTE# 'S=s -155-71ijo' Harnett County Department of Public Health,.-,,-, 2 3 7 7 2
PERMIT # 2�3(0�, � Operation w ration Pe It ��
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New Installation Septic Tank �Nltrlffcatlon Line LTJ Repair ❑ Expansion
PROPERTY LOCATION: -x_/5 -Vi( e5—�—yr
Name: (owner)—5/—At,.)c.r-i i3uTIUs SUBDIVISION ,d,� LOT #
System Installer: S%4-tir i3:rr./s Registration #
Basement with plumbing: ❑ Garage Y Number of Bedrooms 3
Type of Water Supply: ❑ Community C/ Public _❑ Well Distance from well feet
System Type: Z5�ot�gGt SyS�cr� /t,�c-� 1'—`0zL�✓ 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.
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
PERMIT CONDITIONS:
I. Performance:
If. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
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System shall perform in accordance with Rule .1961.
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.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sdisposal system on the above captioned property.
Type of system: El Convent
Conventional Other Z:n%iU°n VC ri Septic Tank: 10 15 O gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches _ Z of each ditch 117,0 feet ditches 3 feet ditches L49 inches
French Drain Required: linear feet
Authorized State A nt _ 1 ! v/, K`_ _ ; Date
15-5-35714R (1)
15-5-35714R (2)
15-5-35714R (3)
15-5-35714R (4)
15-5-35714R (5)
15-5-35714R (6)
15-5-35714R (11)
15-5-35714R (7)
15-5-35714R (8)
15-5-35714R (9)
15-5-35714R (10)