OPHTE#' =s=issy Harnett County Department of Public Health
23917
PERMIT # 2 d 0 eration Per It
New Installation Septic Tank aZNitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION':�IL22/5— Al�"Ca--6,f,7
Name: (owner) SUBDIVISION LOT # a 3
System Installer. '72�51) 3,1a) — Registration #
Basement with plumbing: ❑ Garage umber of Bedrooms 3
Type of Water Supply: ❑ Community EO Public ❑ Well Distance from well feet
System Type: lUkT:auLA%_✓ _btVL Types V and VI Systems expire in S years.
(In accordance with Table V a) Owner moudgMAtAqw.1tepartmerit 6 months prior to expiration for permit renewal.
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I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
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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 ❑
pu,
H2OLire ❑
Following are the specifications for the seeww�Be disposal system on the above captioned property. /oyd
Type of system: ❑ Conventional LVJ Other ZS6/b f7zLWUCZ -N � Septic Tank: /Uy") gallons Pump Tank:
Subsurface No. of exact length'' ��ll width of depth of
Drainage Field ditches of each ditch feet ditches feet ditches
French Dain Required: Linear feet /
Authorized State AgFafs Date `1— Z ° — �C•o
PWR Line
gallons
inches
;."7 6
15-5-36954 (1)
15-5-36954 (6)
15-5-36954 (11)
15-5-36954 (2)
15-5-36954 (7)
15-5-36954 (3)
MIMPE-1 -A
I Jwk
15-5-36954 (8)
rP- I
MR-
-Air
15-5-36954 (12) 15-5-36954 (13)
-A
j
15-5-36954 (4)
15-5-36954 (5)
15-5-36954 (9)
15-5-36954 (10)