OPHTE# 57 -37&7M- Harnett County Department of Public Health 24059
PERMIT # Le(, -7( Operation Permit
19� New Installation Q Septic Tank C7 Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: aXd earc_
Name: (owner) S>>e SUBDIVISION 6icFcacA Ljznc» s LOT # 3r
System Installer.o Registration #
Basement with plumbing: Elmb
Garage E6( Huller of Bedrooms .3
Type of Water Supply: ❑ Community fJ Public ❑ Well Distance from well feet
System Type: 2r r+�ti_� e+¢ P �e c.+riTypes V and VI Systems expire in S years.
(In accordance with Table V a) Owner must =contact Department 6 months prior to expiration for permit renewal.
this system has been Installed In compliance with applicable North tarolma central Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and construction Authorization
2 LID .
V
yD j ,
W
PERMIT CONDITIONS
I. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring: As required by Rule .1961.
111. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
❑
D -Box
❑ Pump ❑
Alarm ❑ H2OLine
❑ PWR Line
Following are the
specifications for
the sewagj-disposal system on the above captioned property.
Type of system:
❑ Conventional
C�Other w-4 Y7ssns+ .s—e--
Septic Tank: 1 " gallons
Pump Tank: gallons
Subsurface
No. of
exact length
width of
depth of
Drainage Field
ditches
S of each ditch 90 feet
ditches feet
ditches inches
trench Drain Required: Linear leet
GL /tdtr�S
Authorized State en Date
L
s`
15-5-37675 (1) 15-5-37675 (2) 15-5-37675 (3) 15-5-37675 (4) 15-5-37675 (5)
-• e— - .-
IP_
3.
15-5-37675 (6) 15-5-37675 (7) 15-5-37675 (8) 15-5-37675 (9) 15-5-37675 (10)
a
3Yj _ s ti.
15-5-37675 (11) 15-5-37675 (12) 15-5-37675 (13) 15-5-37675 (14) 15-5-37675 (15)
15-5-37675 (16)