OP RNTE# IS—S3_7SL 9fZ Harnett County Department of Public Health 24184
PERMIT # 7R,-7 J Operation Per It —/
IJ New Installation Septic Tank Ld Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:X,1u3yc70A4*,,_46
Name: (owner) LLz SUBDIVISION _ LOT # n
System Installer: sr
Registration #
Basement with plumbing: ❑ Garage (umber of Bedrooms
Type of Water upply: ❑ Community Public ❑ Well Distance from well feet
System Type: Z i Types V and VI Systems expire in S yeah.
(In accordance with able Y a) li Owner must contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in
PERMIT CONDITIONS:
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other
General Statutes, Rules for Sewage Treatment and
and all Londitiom of the Improvement Permit and construction Authorization.
ll;
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 -Boz ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: El Conventional C1 Other Z.5%/Ze—)a)0u'7r— Septic Tank: 100 U gallons Pump Tank: ueo gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches It of each ditch feet ditches 3 feet ditches i o inches
French Drain Required: Linear feet
fAuthorized Stat�i�"� Date