OPHarnett County Department of Public Health
HTE# is -s 24070
PERMIT # Z" Operation Per it
New -installation c Tank W Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOEATION s' h
Name: (owner) SZ*tr cnr-r 0 2 5 SUBDIVISION LOT # 134
System Installer: Registration #
Basement with plumbing: ❑ Garage lll�umber of Bedrooms _c�'
Type of Water Supply: ❑ Community LD/ Public ❑ Well Distance from well feet
System Type:2S G Types V and VI Systems expire in S years.
(In accordance with Table V a) Owner must con t Health Department 6 months prior to expiration for permit renewal.
Ihls system has been installed in compliance with applicable north Carolina General Statutes, Pules for Sewage treatment and Dismal, and all conditions of the Improvement Permit and Construction Authorization
PERMIT CONDITIONS
I. Performance:
Il. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
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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 spedfications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional [Y Other Z4vin nst>oL t;! Septic Tank: bU & gallons Pump Tank: gallons
Subsurface No. of c exact length width of depth of
Drainage Field ditches I of each ditch feet ditches 3 feet ditches inches
French Drain Required: Linear feet
Authorized State WE L PPA U4.Aiit' Date (o- Z?—