OP RNTE# /5-s- 36R/0/ Harnett County Department of Public Health 23807
PERMIT # 7841%t Operation Permit
2 New Installation 12� Septic Tank nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: &y_, -i&3 ycame64, Lf Gd-*04�,
Name: (owner) i� jam✓ SfLiJ4QT SUBDIVISION 0414-s Ctzss5a, r_ LOT # -7
System Installer: Registration #
Basement with plumbing: ❑ Garage Number of Bed court 3
Type of Water Supply: 11 Community CV Public E Well Distance from well fe
System Type: ZS% s — G- rs pes V and VI Sy ems expire in S years.
(In accordance with Table V a) Owner must contac Nealth Department 6 months prior to expiration for permit renewal.
1� l
This system has been installed in zomDliance with a0lizable North
PERMIT CONDITIONS:
I. Performance:
If. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
Irl
)
7L
❑ Pump ❑
Alarm ❑ H2DLine
❑ PWR Line
Following are the
1�
the sewaaP� disposal system on the above captioned property.
Type of system:
❑ Conventional
f'Other ?'M i1k60c4-4N_
Septic Tank: / o a o gallons
Pump Tank: gallons
v
No. of
exact length
width of
depth of
Drainage Field
ditches
y of each ditch %S feet
ditches feet
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.
construction Authorization.
❑
D -Box
❑ Pump ❑
Alarm ❑ H2DLine
❑ PWR Line
Following are the
specifications for
the sewaaP� disposal system on the above captioned property.
Type of system:
❑ Conventional
f'Other ?'M i1k60c4-4N_
Septic Tank: / o a o gallons
Pump Tank: gallons
Subsurface
No. of
exact length
width of
depth of
Drainage Field
ditches
y of each ditch %S feet
ditches feet
ditches Z L inches
French Drain Required:
Linear feet
Authorized State A¢ uw� 2- MPoa:wax +`- Date / v - / Z -/ Y_
15-5-3691 OR (1)
15-5-3691OR (2)
15-5-3691 OR (3)
15-5-3691OR (4)
dr w 7- A
15-5-3691 OR (6) 15-5-3691 OR (7)
No
15-5-3691 OR (12)
15-5-3691 OR (11)
7 T/
.I
a,
15-5-3691 OR (8)
15-5-3691 OR (9)
15-5-3691 OR (5)
tt
15-5-3691OR (10)
15-5-3691 OR (13)
15-5-3691 OR (14)
15-5-3691 OR (15)