OPHTE# '3'73-70 Harnett County Department of Public Health 23920
PERMIT #Z8d 0 eration Per It
New Installation EY Septic Tank E /Nitrification Line ❑ Repair ❑ Expansion
p PROPERTY LOCATION: 3-L/Y,s /L+rrls
C07 -16&,j
Name: (ownerC07-16&,j -v"C SUBDIVISION"J LOT #
li-
System Installer: 1&557,-J1 /aha,'// -5 Registration `
Basement with plumbing: ❑ Garage umber of Bedrooms 3
Type of Water Supply: ❑ Community VPu dtc ❑ Well Distance from well feet
System Type: Types V and VI Systems expire in S years.
(In accordance with Table V a) ust contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with Wplicable North Carolina General Statutes, Rules for Sewage Treatment and Dispolial, and
Z4q-1 F�
176
PERMIT CONDITIONS:
1. Performance: System shall perform in accordance ith Rule .19 1
11. Monitoring: As required by Rule .1961.
111. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? es ❑ No
If yes, see attached sheet for addit operation conditions, maintenance and reporting.
IV. Operation:
Permit and (onstruttion Authorization.
V. Other:
❑
D -Box ❑
Pump ❑
Alarm ❑ H2OLine
❑ PWR Line
Following are the
specifications for the sewage disposal
system on the above captioned property.
Type of system:
❑ Conventional [{ other 75'%iZ"..t)00761)
,�uSW- -._
Septic Tank: &0 gallons
Pump Tank: gallons
Subsurface
No. of
exact length
width of
depth of
Drainage Field
ditches q
of each ditch 86 feet
ditches —>� feet
ditches inches
French Drain Required: Linear feet
Authorized State A '% Date 3—f —1/(o
15-5-37378 (1)
15-5-37378 (6)
15-5-37378(2)
15-5-37378 (3)
15-5-37378 (4)
15-5-37378 (5)
15-5-37378 (7)
15.5-37378 (8)
15-5-37378 (9)
15-5-37378 (10)
15-5-37378(11) 15-5-37378(12) 15-5-37378(13)
15-5-37378 (14)
15-5-37378 (15)