OP RHTE#15— J=Y?Eb4`JQ, Harnett County Department of Public Health 24015
PERMIT # ���� Operation Permit
New Installation Segtic Tank Nitrification Line ❑ Repair El Expansion
v \, PROPERTY LOCATION: D156"J L�
Name: (owner) ms� U—C— SUBDIVISION OPQ,?-r"csNT LOT # L
System Installer: Gno�E. G PR.a-462 Registration #
Basement with plumbing: ❑ Garage '5i� Number of Bedrooms
Type of Water Supply: ❑Community Public ❑ Well Distance from well : feet
System Type: 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 Statures, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
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YMPIll LUNUIIIUNN:
I. Performance: System shall perform in accordance with Rule .1961.
II. Monitoring: As required by Rule .1961.
111. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ N X
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned pr erty.�
Type of system: Conventional � Other 9v+ eT c- GNJPnp(Xly� Septic Tank gallons Pump Tank:t °dC1% gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch Y`a d feet ditches 3 feet ditches le inches
French Drain Required Linear feet
Authorized State Agent ���� . za-» Date �I ]G