OPHTE#«-3��� Harnett County Department of Public Health 23824
PERMIT # `-"5QA Operation Permit
New Installation '�K Septic Tank 'X Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:
Name: (owner) Weowest. "01^C-5 14c. SUBDIVISION Pi-7,nN, LOT # S
System Installer: 07,.5 SZcl.,-, Registration #
Basement �� Garage WNumber of Bedrooms 3
Type of Water Supply: ❑ Community K Public ❑ Well Distance from well <l O 0 feet
System Type: ATF 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.
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
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I. Performance: System shall perform in accordance with Rule .1961.
If. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ NoA
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other. SYs-rr_'t�[Slsr '�vG 10 CH --66- of a,JE L.ocpcnaN Sa'L. \«A%
❑ D -Box ❑ Pump ❑ Alarm ❑
H2OLine ❑
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional Other LZ- VLo. Septic Tank: S 00 0 gallons Pump Tank:
Subsurface No. ofexact length width of depth of
Drainage Field ditches �_ of each ditch =DO feet ditches feet ditches+'
French Drain Required: Linear feet
Authorized State Agent %,'5 Date VjWls—
PWR Line
gallons
inches