OP RHTE# IT— S-- 3'5_486Z Harnett County Department of Public Health 23785
PERMIT # ?RVL0 Operation P"Mit
1f New Installation LJ Septic TankNitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:, -,5:e_ yj8q t -,ca 69,o o e_,b
Name: (owner)/Yale 7;;-,JA,� SUBDIVISION (_pijx-s, T �c L _ LOT # e
System Installer: —T%jA rte Mthoir-__ rtc_. Registration # 31-11
Basement with plumbing: ❑ Garage Eg' Number of Bedrooms J
Type of Water Supply: ❑ Community 5J Public ❑ Well Distance from well i00 `'+" feet
System Type: S /ott ?� -6� C_ Q -z Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must conta t 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
rtnrnI LUNUIIIUN):
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
L --D
cr _ g.
low
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 sewa a disposal system on the above captioned property.
Type of system: ❑
Conventional Other
>S°lo (ZC4Vc.X"Lz'Q :gu 0a—
Septic Tank: 1000 gallons Pump Tank: gallons
Subsurface
No. of
exact length
width of depth of
Drainage Field
ditches _
of each ditch Rte feet
ditches feet ditches Za> t inches
French Drain Required:
Linear feet
Authorized State ent - --m t, � "' Date % ;'(° _/'
15-5-35480R (1) 15-5-3548OR (2) 15-5-3548OR (3) 15-5-3548OR (4) 15-5-3548OR (5)
15-5-3548OR (6) 15-5-3548OR (7) 15-5-3548OR (8)