OP RHTE# 157--5-_ns T1-(2 Harnett County Department of Public Health
24051
PERMIT # z Operation Permit �
C3/New Installation LN' Septic Tank Ek Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: SL/Y3zfcTahr+s.+—eta
Name: (owner) 6A7t.1, 1261or4s,,4v. Ur- SUBDIVISION LOT # 9
System Installer. d'u Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms a
Type of Water Supply: ❑ Community Eol'�Public ❑ Well Distance from well feet
System Type: '5% s tTa G Types V and VI Systems expire in 5 years.
(In 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 applicable North Carolina General Statutes, Rules four Sewage Treatment and * posal, and all conditions of the Improvement Permit and Construction Authorization.
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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 ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional IY Other Aecc4eSeptic Tank: 103 d gallons Pump Tank gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch ane feet ditches 3 feet ditches f F- inches
French Drain Required: Linear feet
Authorized State Ae to -,—V-,�r� ` %�y� /+.. % �%x Date 4 — z-- 1
15-5-37574 (1)
15-5-37574(2)
15-5-37574 (3)
15-5-37574 (4)
15-5-37574 (5)
15-5-37574 (6)
15-5-37574 (7)
15-5-37574 (8)
15-5-37574 (9)
15-5-37574 (11)
15-5-37574 (12)
15-5-37574 (13)
15-5-37574 (14)
15-5-37574 (10)
15-5-37544R (1)
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r
7 i
15-5-37544R (2)
15-5-37544R (3)
15-5-37544R (4)
15-5-37544R (5)
15-5-37544R (6)
15-5-37544R (11)
15-5-37544R (7) 15-5-37544R (8)
15-5-37544R (12) 15-5-37544R (13)
15-5-37544R (9)
15-5-37544R (10)