OPHTE# 1:5'--S--3-73 9L, Harnett County Department of Public Health 23907
PERMIT # ZP,55"7 0 eration Permit j
12 New Installation Septic Tank CJ Nitrification Line ❑ Repair ❑ Expansior
PROPERTY LOCATION:aiyNy
Name: (owner) SUBDIVISION LOT # 3
System Installer: Zuf/%5 .tl -Ph:IIRegistration #
Basement with plumbing: ElGarageHumber of Bedrooms 3
Type of Water Supply: ❑ Community FRI Public ❑ Well Distance from well feet
System Type:5%Z84)u -± 3CJ--t1---- Types V and VI Systems expire in S years.
(In accordance with Table V a) I Owner mus conta t Health Department 6 months prior to expiration for permit renewal.
This system has been installed in comoliance with aonlicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
1. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
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I1:15 ;�J-ss.
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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 sewagrdisposal system on the above captioned property.
Type of system: ❑ Conventional Other Z S% �l%V G17" Septic Tank: / o't+-o gallons Pump Tank: ° c"° gallons
Subsurface No. ofexact length width of depth of
Drainage Field ditches 5 of each ditch LC' feet ditches 3 feet ditches (,�-�,is inches
French Drain Reauired: linear feet
Authorized State A ¢� l7 %y�A,/447, ✓ Date Z — I `1 It �a
15-5-37398 (1)
15-5-37398 (6)
15-5-37398 (11)
15-5-37398 (16)
15-5-37398 (2)
15-5-37398 (7)
15-5-37398 (12)
15-5-37398 (3) 15-5-37398 (4)
15-5-37398 (5)
15-5-37398 (8)
15-5-37398 (13)
15-5-37398 (9)
15-5-37398 (14)
15-5-37398 (10)