OPHTE# /s a`- 3'7'74(. Harnett County Department of Public Health 24043
PERMIT # 2 B49 8$ Operation P"Sept
Q� Neww Installation C� Septic Tank Q� Nitrification Line ❑ Repair ❑ Expansior
PROPERTY LOCATION,avvva s itp
Name: (owner) 6)W 8/e (�_ _� SUBDIVISION � s v�(a,r� LOT # /.3_
System Installer: _ c.ae i� r * eRL� Registration #
Basement with plumbing: ❑ Garage fY Number of Bedrooms 3
Type of Water Supply: ❑ Community FR'/Public ❑ Well Distance from well feet
System Type: 5vo t Types V and VI Systems expire in S years.
(1n accordance with Table V a) Owner mus contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with appliable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and tonstrucuon numomanon.
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PERMIT CONDITIONS
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
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 ❑
Following are the specifications for the sew ge disposal system on, the above captioned property.
Type of system: ❑ Conventional L Other 1S%'n zauyz-r^-- Septic Tank:
Subsurface No. of exact length width of
Drainage Field ditches 3 of each ditch ua feet ditches 3
H2O1-ine ❑
PWR Line
gallons Pump Tank gallons
depth of
feet ditches 21 -) 'C6 inches
French Drain Required: Linear feet
� /
Date
Authorized State A nt�
15-5-37746 (1)
15-5-37746 (2)
15-5-37746 (3)
15-5-37746(4)
15-5-37746 (5)
15-5-37746 (6)
15-5-37746 (11)
15-5-37746 (7)
15-5-37746 (8)
15-5-37746 (9)
15-5-37746 (10)