OP RRRHTE# Harnett County Department of Public Health
24038
PERMIT # Z`C3G(Q5— Operation Permit
12( New 'Installation c Tank Nitrification line ❑ Repair ❑ Expansion
PROPERTY LOCATIOI+4-M7 24lA5 (/,FEET
Name: (owner) 7-o6f44 A --),.fT,,, SUBDIVISION LOT #
System Installer: J Registration #
Basement with plumbing: ❑ I Garage 9 Number of Bedrooms 3
Type of Water Supply: ❑ Community (Public ❑ Well Distance from well feet
System Type: :2!�go-r /tt Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must con t Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable Nonh Carolina Geneml Statute, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construnion Whoriaauon.
va
PERMIT CONDITIONS:
I. Performance:
H. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
1
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 ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewa disposal system on the above captioned property.
Type of system: ❑ Conventional ( Other 1> R/:'Du Gf—i&> Septic Tank: I ooa gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage field ditches 7' of each ditch by feet ditches 3 feet ditches 29 -) I inches
French Drain Required:
Linear feet
Authorized State Agent4�
—�1
Date q - 75 '
15-5-37314RRR (1)
15-5-37314RRR (2)
15-5-37314RRR (3)
M-F:
15-5-37314RRR (4)
15-5-37314RRR (5)
15-5-37314RRR (6)
15-5-37314RRR (7)
15-5-37314RRR (8)
15-5-37314RRR (9)
15-5-37314RRR (10)