OPHTE#QS-- 5 —3117p Harnett County Department of Public Health 24180
PERMIT # 29,StA / Operation Pit
G2' New Installatione mSeptic Tank LCSi//
Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATIONayy37A54o9A7&,,2P x-6
Name: (owner)-S7ArAf-K—f )3iz'1 Ziac SUBDIVISION / LOT # 38
System Installer:( B Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms
Type of Water Sup�ly: ❑ Community Public El Well Distance from well feet
System Type: 1'i /+1Z0.v j tZ,Types V and VI Systems expire in S years.
(In accordance with Table V a)contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in
Rules far Sewaue Treatment and
;ems I D A_
all conditions of the Improvement Permit and Construction Authorisation.
41
to
PERMIT CONDITIONS:
1. 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 sewgge disposal s stem on the above captioned property.
Type of system: ElConventional M Other'LS�b (Z&ri Septic Tank: 100 0 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch go feet ditches 3 feet ditches 2 q inches
French Drain Required: Linear feet
Authorized State A ntF t 1o., 2 AIIA-4-,_� Date —7 — I I— ) G
15-5-37170 (7)
15-5-37170 (8)
15-5-37170 (9)
15-5-37170 (10)
15-5-37170 (11)
15-5-37170 (12)
15-5-37170 (17)
15-5-37170 (13)
15-5-37170 (14)
15-5-37170 (15)
15-5-37170 (16)