OPHTE# /5 - S— 31134 Harnett County Department of Public Health 24069
PERMIT # 7b -5-&C, Aeration Per It /
New Installation Septic Tank L Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOfATION3n 1452
Name: (owner) 6771-nscx_i jf�s bA-s zZA- SUBDIVISION d2g:2P.!C,. /1— LOT # /yi—
System Installer:— ,,r te !ae wrt-o �, ._ Registration #
Basement with plumbing: ❑ Garage h�/Number of Bedrooms :?
Type of Water Supply: ❑ Community Eif Public ❑ Well Distance fromyvell feet
System Type: f % akion, o ca'L, — a49— % '-Types V and VI Systems expire in S years.
(In accordance with Table V a) toOwner musi♦ contact Health Departs ent 6 months prior to expiration for permit renewal.
has been installed in <omoliance with apolicable North Carolina General Statutes, Rules fousewaee Treatment and Disposal, and all
PERMIT CONDITIONS
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
oo
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.
and construction Authorization.
❑ D -Box ❑ Pump ❑ Alorm ❑ H2OLine ❑ PWR Line
following are the specifications for the sewa disposal system on the above captioned property.
Type of system: ❑ Conventional 71 ther44-`)-&&f o.s7r Septic Tank: r d U U gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches t of each ditch � feet ditches S feet ditches 1,qa inches
French Drain Required: Linear feet
Authorized State Age��� �_T� Date 17
/fl —��
15-5-37234 (1)
/ .rC
15-5-37234 (2)
15-5-37234 (6)
15-5-37234 (11)
15-5-37234 (7)
15-5-37234 (3)
x
15-5-37234 (8)
15-5-37234 (4)
15-5-37234 (9)
15-5-37234(12)
15-5-37234 (13)
15-5-37234 (14)
15-5-37234 (5)
15-5-37234 (10)