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Harnett
founty Department of Public Health
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23906
PERMIT# 2077' 8
, Operation PeT
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Q New Installation Cv7 Septic Tank ER' Nitrification Line
❑ Repair ❑ Expansion
PROPERTY LKATION:Zsc. ,/gP, *Pe-aas az
Name: (owner)
SUBDIVISION
LOT #
System Installer: L&5 seQ(
-1;.(..llc„ S
Registration #
Basement with plumbing: ❑ Garage
Q NuBedrooms
Type of Water Sup I : ❑ Community
'"
LH Public ❑
Well Distance from well feet
System e' IZ6bV —S`-
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Z ypes V and VI Systems expire in S years.
(In accordance with Table V a)
Owner Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable Norah Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement remit and tonshualon Rdlhnnaatlon.
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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 ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sewa a disposal system on the above captioned property.
Type of system: ElConventional 70ther24". 1200V 0 �n--S. 4,r— Septic Tank: 1000 gallons Pump Tank: I a o gallons
Subsurface No. of exact length 7 width of depth of
Drainage Field ditches S of each ditch —10 feet ditches 3 feet ditches inches
French Drain Required: Linear feet
Authorized State APE \-r- i2 � —�� v Date L -I-) - /&
15-5-37399(1) 15-5-37399(2) 15-5-37399(3) 15-5-37399(4) 15-5-37399(5)
15-5-37399(6) 15-5-37399(7) 15-5-37399 (8) 15-5-37399 (9) 15-5-37399(10)
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15-5-37399 (11) 15-5-37399(12) 15-5-37399(13) 15-5-37399(14) 15-5-37399(15)
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