OPHTE# S-3 (r Harnett County Department of Public Health 23793
PERMIT # Zf 3 -►3 0 eratlon Per It
Ca' New 'Installation c Tank 2 Nitrification Line ❑ Repair ❑ Expansion
_ PROPERTY LOCATION: z7
Name: (owner) -4R7vt;e. on a/ SUBDIVISION LOT #
System Installer: Registration #
Basement with plumbing: ❑ Garage 21umber of Bedrooms 3
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type:— s32 Types V and VI Systems expire in 5 years.
(In accordance with Table V a) t Owner must c ealth Department 6 months prior to ezQiration for permit renewal.
This system has been installed in compliance with appliable No h Carolina General Statu s, Rules` for Sewage Treatment d Disposal, and all conditions of the Impro ement Permit and Comusumon Authorization.
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PERMIT CONDITIONS:
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
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.
✓ I
v
❑ D•Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: El Con onal C�7 Other 74�0-104-t� Sri�6 Septic Tank: 1060 gallons Pump Tank: / 0 GV gallons
Subsurface No. of exact length 7 width of depth of
Drainage Field ditches of each ditch /"0 feet ditches 3 feet ditches Z' _) inches
French Drain Required: Linear feet
Authorized State AgttQ,���� Date 12 — # U — y 5
e ,1 C R i. ♦ Rry� , now, >
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15-5-35436 (6) 15-5-35436 (7) 15-5-35436 (8) 15-5-35436 (9) 15-5-35436 (10)
15-5-35436 (11) 15-5-35436 (12) 15-5-35436 (13) 15-5-35436 (14) 15-5-35436 (15)
15-5-35436 (16) 15-5-35436 (17) 15-5-35436 (18) 15-5-35436 (19) 15-5-35436 (20)
15-5-35436 (21) 15-5-35436 (22) 15-5-35436 (23) 15-5-35436 (24) 15-5-35436 (25)
15-5-35436 (26) 15-5-35436 (27) 15-5-35436 (28) 15-5-35436 (29) 15-5-35436 (30)
15-5-35436 (31) 15-5-35436 (32)