OPHTE#Is :5-- -5 -7 -t;-- Harnett County Department of Public Health
23803
PERMIT # Z 823Operation Permit ��
New Installation C�Septic Tank Eel itrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: Ck,cZor o,r-a
Name: (owner)�'!— D.���T,r. = &A,—, : � SUBDIVISION L9:!!4z L.L_.. eY LOT #
System Installer: (7rr-X --- s Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms `i
Type of Water Supply: ❑ Community E?"Public ❑ Well Distance from well feet
System Type: /?S. �CA.A uWZti*y ..�ria_r �.urG s V and VI Systems expire in S years.
(In accordance with Table V a) / , Owner not contactct HDepartment 6 months prior to expiration for permit renewal.
This system has been installed in compliance wiappkable North Carolina General Statutes, Rules I
Cl —
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
Pc" -C- C7/-
1.
i
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.
of the Imorovement Permit and Construction Authoriution.
❑ —D -Box ElPump ❑ Alarm ❑ 1-1201-ine ❑ PWR Line
Following are the specifications for the sewa disposal system on the above captioned property.
Type of system: ElConventional ther cY r V Kti S Septic Tank: /tse gallons Pump Tank gallons
Subsurface No. of exact length width of depth of
Drainage field ditches L of each ditch / So feet ditches 3 feet ditches 30'7/8 inches
french Drain Reouired: Linear feet
Authorized State 1� Z - — Date 9 , -Zj — 1�r—
f
- A
15-5-35475 (1) 15-5-35475 (2) 15-5-35475 (3) 15-5-35475 (4) 15-5-35475 (5)
15-5-35475 (6) 15-5-35475 (7) 15-5-35475 (8) 15-5-35475 (9) 15-5-35475 (10)
15.5-35475(11) 15-5-35475(12) 15-5-35475(13) 15-5-35475(14) 15-5-35475(15)
15-5-35475 (16)