OP RHTE# /S -s —351 75/Z! Harnett County Department of Public Health 23780
PERMIT # 28388 /OperafionEw Installation Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION 53
Name: (owner) SUBDIVISION LOT # q
System Installer: 477Z5 Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms .3
Type of Water Supply: ❑ Com unity Public ❑ Well Distance from well feet
System Type: 25S T JXr' P7'Z:Ty es V and VI Systems expire in 51 years.
(In accordance with Table V a) Owner must Contac th Department 6 months prior expiration for permit renewal.
This system has been installed in compliance with
PERMIT CONDITIONS:
I. Performance:
11. Monitoring:
111. Maintenance:
IV. Operation:
icable Nort�,Carolina General Statutes, Rules for Sewage Treatment and Disposal,
MI -1
:w— 1i0s •3 IX4*', 9b
conditions of the Improvement Permit and Construction Authorization.
L— -P
'713'
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.
V. Other.
❑ D -Bax ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the seewwa disposal system on the above captioned property.
Type of system: El Conventional L�' OtherSeptic Tank: gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches -� of each ditch o J feet ditches feet ditches 2 inches
French Drain Rettuired: Linear feet
Authorized State Ae�L �-, ---�� ����.,,�..Date ¢o — I -I " I 'S�J
15-5-35979R (1)
15-5-35979R (2)
15-5-35979R (3)
15-5-35979R (4)
15-5-35979R (5)
15-5-35979R (6)
15-5-35979R (7)
15-5-35979R (8)
15-5-35979R (9)
15-5-35979R (11)
15-5-35979R (12)
15-5-35979R (13)
15-5-35979R (14)
15-5-35979R (10)