OPHTE#15-5-"`1�1 Harnett County Department of Public Health 23984
PERMIT # 2336 Operation Permit
New Installation Septic Tank Nitrification Line ❑ Repair ❑ Expansion
Name: (owner) PROPERTY LOCATION: Opo Js 411
SUBDIVISION Pg
Loiz- LOT #
System Installer: C-cc<t.o c N Registration #
Basement with plumbing: ❑ Garage 'T�< Number of Bedrooms
Type of Water Supply: ❑ Community '�K Public ❑ Well Distance from welli� feet
System Type: =M_10 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.
This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment 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.
II. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ Nox
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine Cl PWR Line
Following are the specifications for the sewage dispose I system on the above captioned propjrty. M
Type of system: ❑ Conventional lzq Other f UYnv`To Q'sgsrg/,r/ \.,Q1") Septic Tank: tOGa gallons Pump Tank: 100 iy gallons
Subsurface No. of \ exact length width of depth of
Drainage Field1 of each ditch a'�� feet ditches 3 feet ditches Wit -I { inches
French Drain Required: �Ciinear feet
Authorized State Agent Date 3