OPHTE# l'- Harnett County Department of Public Health 23900
PERMIT # Operation Permit
IJ New Installation 9 Septic Tank E Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LO(ATION:,R_a/S7
Name: (owner) 3'zwl, SUBDIVISION _ moi /v T oar r�� LOT # /G P
System Installer: .YA�1 &'r't1e3�c5 Registration #
Basement with plumbing: ❑ Garage I� Number of Bedrooms
Type of Water Supply: ❑ Community l' Public ❑ Well Distance from well feet
System Type: Z r?y1-i;uu'ca'±G__7 =r c eZ �_ 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 insulted in compliance with applicable Nonh Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement remit and Lomau[aon numonnnon.
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il
Q51
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74 w
PERMIT CONDITIONS:
I. Performance:
ll. 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 Tank: gallons
Pump
❑
Alarm ❑
H2OLine
❑
PWR Line
Following are the
Type of system:
specifications for
❑ Conventional
the
sdisposal
ewage
Other LS'/s
system on the
ft
above captioned property.
French Drain Required: Linear leet
Authorized State A �nt ��.�—��-- � � �i°v��vlL,E;' Date 2- - 1 'L-- I to
r�fz�
Septic Tank: Ice ° gallons
Pump Tank: gallons
Subsurface
No. of exact length 6 9
width of
depth of
Drainage Field
ditches 3 of each ditch _ feet
ditches .i feet
ditches i u r inches
French Drain Required: Linear leet
Authorized State A �nt ��.�—��-- � � �i°v��vlL,E;' Date 2- - 1 'L-- I to
15-5-37255 (1)
15-5-37255 (2)
15-5-37255 (3)
15-5-37255 (4)
15-5-37255 (5)
15-5-37255 (6)
15-5-37255 (7)
15-5-37255 (8)
15-5-37255 (11) 15-5-37255 (12) 15-5-37255 (13)
15-5-37255 (9)
15-5-37255 (14)
15-5-37255 (10)