OPHTE# / 5--- ` =3y847 Harnett County Department of Public Health 23887
PERMIT # 2d370 O eraerattionn Permit
2/New Installation Lv Septic Tank LJ Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: 7x./vzo ; ? G, .t/9
Name: (owner) _dA926(-Z /gym SUBDIVISION LOT # /
System Installer: o •, Registration #
Basement with plumbing. ❑ Gamg ❑ Number of �Bejd ooms 3
Type of Water Supply: ❑ Community El Public ER' Well Distance from �well )00' r feet
"
System Type: � r r .,�I 6 R V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must ontact ealth Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Se a e Treatment and Disposal, and all conditions of the Improvement Permit and Comtruainn Authorization.
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job
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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.
❑
D -Box ❑
Pump ❑
Alarm ❑ H2OLine ❑ PWR Line
Following are the
specifications for the sew a disposal
system on the above captioned property.
Type of system:
❑ Conventional Other 7
6 ��u�1.tn
Septic Tank: 10 6 J gallons Pump Tank: gallons
Subsurface
No. of
exact length
width of depth of
Drainage Field
ditches 3
of each ditch 8b feet
ditches 3 feet ditches ZO ) I8 inches
French Drain Required: Linear feet
Authorized State A .nt�cG�� Date 1 — 15 — I (�
15-5-35847 (1) 15-5-35847 (2) 15-5-35847 (3) 15-5-35847 (4) 15-5-35847 (5)
15-5-35847 (6) 15-5-35847 (7) 15-5-35847 (8)