OPHTE# Harnett County Department of Public Health 23794
PERMIT # 2039A Operation Permit
9 Neww installation Tank C2` Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION
Name: (owner) A� �.e�.�s.-�_ SUBDIVISION LOT # A
System Installer, o .ea Registration #
Basement with plumbing: ❑ Garage umber of Bedrooms
Type of Water Supply: ❑ Community f3 Public ❑ Well Distance from well feet
System Type: Z5% rZ&DUCS4-,;h_5 � 9V - r—±Types V and VI Systems expire in S years.
(In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
[his system has been installed in compliance with applicable North Lavolma 4eneral Natures, Rules lur sewage Ireatment and Disposal, and all conditions of the Improvement Permit and Lonstruction Authorization
PERMIT CONDITIONS
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
2
G I Jf'� 4O SD
v
�r9ao IDA< ✓nst�., �
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 ❑
H2OLme ❑
PWR Line
Following are the
specifications for
the sew disposal system on the above captioned property.
Type of system:
EI Conventional
Other ZMZ41svart — S,SM
Septic Tank: 1011 gallons Pump Tank: gallons
Subsurface
No. of
exact length
width of depth of
Drainage Field
ditches
3 of each ditch I D feet
ditches 3 feet ditches Z f inches
french Drain Required: Linear feet
Authorized State Date
LJ
15-5-36255 (1) 15-5-36255 (2) 15-5-36255 (3) 15-5-36255 (4) 15-5-36255 (5)
15-5-36255 (6) 15-5-36255 (7)
do
15-5-36255 (8)