OPNTE# /S-s--57Z-b Harnett County Department of Public Health 23903
PERMIT # 7,65-99 Operation Permit
E9 New Installation 0 Septic Tank 0 Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATIONS/Hi /-A
Name: (owner) &41 411/s ;.b �ArJU/J SUBDIVISION d 02(k rn LOT #
System Installer.. Registration # Ir
Basement with plumbing: ❑ Garage f_/ umber of Bedrooms
Type of Water Supply: El Community L�' Public ❑ Well Distance from well feet
System Type: 6 x= Types V and VI Systems expire in S years.
(In accordance with Table V a) I fwner must contact e t epart nt 6 months prior to expiration for permit renewal.
has been installed in compliance with
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
Carolina General Statutes, Rules for Sewage Treatmeri jilgisposa
z
V
all conditions of the Improvement Permit and construction Authorization.
System shall perform in accordance with Rule .1961.
As requited 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 sew a disposal system on the above captioned property.
Type of system: ❑ Conventional f Other Z01, �f5it._- Septic Tank: / 6' c) gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch /00 feet ditches .'i feet ditches 261-1/ inches
French Drain Reauired: Linear feet
Authorized State trent <—`— /' (f/Tr/uF 'Y — Date L -/ 9 —
15-5-37283 (1)
15-5-37283 (2)
i
15-5-37283 (3)
15-5-37283(4)
xcC,,
15-5-37283 (5)
15-5-37283 (6)
15-5-37283 (11)
15-5-37283 (7)
15-5-37283 (8)
15-5-37283 (9)
15-5-37283 (10)