OP RHTE# 1�5 _5 3"- 1e Harnett County Department of Public Health 23890
PERMIT # " S -S L1 Operation Permit
0 New Installation 0 Septic Tank 9 Nitrification line ❑ Repair ❑ Expansion
PROPERTY LOfATION:mr 1532- Offkti5—" _ /L/-)
Name: (owner) F2."lC SUBDIVISION ifs �/r�a-/ LOT # Lc
System Installer: ieFd tti Registration #
Basement with plumbing: ElGarage ElNumber of Bedrooms`I'
Type of Water Supply: ❑ Community I' Public ❑ Well Distance from well feet
System Type: Z5"- RPtjucctcs,3 T"na11( G Ch�r_A. res V and VI Systems expire in SI years.
(In accordance with Table V a) Owner must contactye -�jij ealth Department 6 months prior Ipo expiration for permit renewal.
This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and
PERMIT CONDITIONS:
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
lk,
and all conditions of th} Improvement Permit and Construction
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 -Boz ❑ Pump ❑ Alarm ❑ H20Line ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional E3 Other 25% aeta,1 c r r"L Septic Tank / [1 r✓ gallons Pump Tank gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches Z of each ditch 36b feet ditches 3 feet ditches ZL� I `� inches
French Drain Required: Linear feet
Authorized Stategent- r Date 1
f
15-5-36639R (1)
15-5-36639R (2)
15-5-36639R (3)
15-5-36639R (4)
15-5-36639R (5)
15-5-36639R (6)
15-5-36639R (7)
15-5-36639R (11) 15-5-36639R (12)
15-5-36639R (8)
15-5-36639R (9)
15-5-36639R (10)