OPHTE# 15--5 37D85: Harnett County Department of Public Health 24079
PERMIT # Operation Permit
New Installation ❑ Septic Tank ,< Nitrification Line ❑ Repair XExpansion
PROPERTY LOCATION: S15 QA
Name: (owner) SUBDIVISION LAS Caesrvivw LOT # -7--
System
System Installer: Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms L
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: G%;' )S'S t C. 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 Ranh Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authonzabon
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 ❑
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional ❑ Other
Subsurface No. of exact length
Drainage Field ditches of each ditch feet
French Drain Required: 1 � �tinear feet
Authorized State
Alarm ❑
_ Septic Tank:
width of
ditches
Date
H2OLine ❑
gallons Pump Tank
depth of
feet ditches
JY_
PWR Line
gallons
inches
FA
HARNETT COUNTY HEALTH DEPARTMENT N- 16 011
ENVIRONMENTAL HEALTH SECTION
OPERATIONS PERMIT
Name: (owner) kt_ `-+nPyA� t>� �1> #-New Installation X 4septic Tank
Property Location: SR# ❑ Repairs ONitrification Line
Subdivision L* r Cce-dv +r Lot #
1 :�7
(� Quadrant #
Contractor. U A f -I r^ s P AC k l,'3 -c Registration #
Basement with Plumbing: ❑ Garage:
Water Supply: ❑ Well 'Public ❑ Community
Distance From Well: SD ft.
Following are the specifications for the sewage disposal system on above captioned property.
Type of system: )iLconventional ❑ Other
Size of tank: Septic Tank: 6-3 ') gallons
Pump Tank: gallons
Subsurface No. of exact lengthwidth of depth of
Drainage Field ditches of each ditch k o ft. ditches 3 ft. ditches
French Drain: J x Linearfeet �0l
Date: J. X)V�
PERMIT NO. Inspected by:
E�6rorunental Health Specialist
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