OPHTE# IS-s=�o s'� Harnett County Department of Public Health 24096
PERMIT # 1�,'3�'1 Oaeration Permit
k Nitrification Line El ❑Expansion
New Installation Septic Tan
PROPERTY LOCATION: Rr,w_s G>uc, cA. Rfl
Name: (owner) CA,jN6-t_ EsREST M¢r0t&'t,g SUBDIVISION LOT #
System Installer. Jlaso t MP; —1\ 14 -As Registration #
Basement with plumbing: ❑ Garage ❑—itesnbereF-Bedroenn 0 �'�ocaSE STr=c3c.E
Type of Water Supply: ❑ Community ElPublic Well Distance from well a 04 feet
System Type: 'TC i Types V and VI Systems expire in S years.
(In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Carolina Gtneral Statures, Rules for Sewage Treatment and Disposal, and all conditions of the Impmeensent Permit and construction Authurmnon
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PERMIT CONDITIONS:
I. Performance: System shall perform in accordance with Rule .1961.
IL Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ Nor
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 a disposal s stem an the above captioned properly.
Type of system:
❑ Conventional
Other E."2,'Vt.Csv,r Septic Tank: 1000
gallons Pump Tank gallons
Subsurface
of
exact length width of
depth of
Drainage Field
ditches _
of each ditch 45 feet ditches 3
feet ditches inches
French Drain Required:
LI feet
Authorized State Airent �� Date -1111'-1114,