OP RHTE# 1S- 5-311' 00- Harnett County Department of Public Health 23978
PERMIT # 145`at-1 Operation Permit
New Installation Septic Tank Nitrification Line F-1Repair El Expansion
PROPERTY LOCc
ATION: �"?wt_c v , Vo
Name: (owner) \ r_ ct+6a st'+ V k s.QLVE SUBDIVISION LOT #
System Installer: Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms ?i a
Type of Water Supply: ❑ Community 'X Public ❑ Well Distance from well 100 feet
System Type: = . 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.
mis system has been installed in compliance mth apphoalife North Carolina General Statutes, Rules for Sewage Ireatmem and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
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PERMIT CONDITIONS
I. Performance: System shall perform in accordance with Rule .1961.
If. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ Noo
If yes, see attached sheet for additional operation cc
IV. Operation:
V. Other.
maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sewage disposal,,...s.iistem on the above captioned property.
Type of system: El Conventional Other C.Z-- Cs ow Septic Tank: I80C) gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field �'t- of each ditch D feet ditches feet ditches f Q inches
french Drain Required: — \ .Linear feet
Authorized State Agent_ Date
|5-534 ^0(L