OP (2) - ADDITION OF DRAINFIELD DUE TO BLDG ENCROACHMENTHT//E# Os-5-152Sa Harnett County Department of Public Health 23871
PER5--077 M# ZZ -5-82 Operation Permit
❑ New Installation ❑ Septic Tank 21"Nitrification Line ❑ Repair ❑ Expansion
/� � PROPERTY LOCATION: Ss
Name: (owner) I�.ruito df-r✓a..a L.C7f Llrt A-" SUBDIVISION i3 fe> LOT # 9,e
System Installer: ,*td Registration #
Basement with plumbing: ❑ GarageNumber of Bedrooms .3
Type of Water Supply: ❑ Community XPublic ❑ Well Distance from well feet
System Type: 2tMd.'-'4"Uzrw� 4.7-- a i & " 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
Neu) L311rljr a
stip
*mcg
wos
4-n 1hiii-
vlA°)t 114
Treatment and Disposal, and all
PERMIT CONDITIONS:
I. Performance:
System shall perform in accordance with Rule .1961.
II. Monitoring:
As required by Rule .1961.
111. Maintenance:
As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and
reporting.
IV. Operation:
V. Other:
❑
D -Box ❑ Pump ❑ Alarm
❑ H201-ine
❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
�aoo
Type of system: LlLT
Conventional Other %504le*v>✓truce-
Septic Tank: /DOO gallons
Pump Tank: gallons
Subsurface
No. of exact length
width of
depth of
Drainage Field
ditches of each ditch /0 feet
ditches .3 feet
ditches 1 Z inches
french Drain Required: Linear feet
Authorized StateA tg -� ��/�nz Date L/-ZA/—is--