OPHTE# /L- s-37i4'j Harnett County Department of Public Health 24067
PERMIT # 'Me-I -r Operation Per It
L;3New Installation Septic Tank 2 Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION GZaif1,4s tdy,C.-t4� Ab
Name: (owner) 2W C SUBDIVISION 4. y4/.6�o LOT # T_
System Installer: v Registration #
Basement with plumbing: ❑ Garage 9 Number of Bedrooms
Type of Water Supply: ❑ Community IV Public ❑ Well Distance from well feet
System Type: Z$% T Pdt es and VI Stems expire in S years.
(In accordance with Table V a) wner must contact He h Department 6 months prior to expiration for permit renewal.
PERMIT CONDITIONS:
I. Performance: System shall perform in accordance with Rule .1961.
If. 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 sewa "disposal system on the above captioned property.
Type of system:
E -Conventional Other 9f'l9A)VcXl
e—
Septic Tank: I Z O gallons
Pump Tank: gallons
Subsurface
No. of
exact length
width of
depth of
Drainage Field
ditches
of each ditch I feet
ditches 3 feet
ditches Ly inches
French Drain Required: Linear
feet
_
Authorized State Ayo lr ,�, /' l Pm Date
16-5-37847 (1) 16-5-37847 (2)
16-5-37847 (3)
16-5-37847 (4)
Y
16-5-37847(5)
1
16-5-37847 (6)
16-5-37847 (11)
16-5-37847 (7) 16-5-37847 (8) 16-5-37847 (9) 16-5-37847 (10)
'Y
Ai
16-5-37847 (12) 16-5-37847 (13) 16-5-37847 (14) 16-5-37847 (15)
16-5-37847 (16) 16-5-37847 (17) 16-5-37847 (18) 16-5-37847 (19)