OPHTE# I c s 39()0'4 Harnett County Department of Public Health 24334
PERMIT Af Z%q14 Operation Permit /
Rr New Installation Septic Tank Ei Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: S 2 ly Z % ohalYhrenL[_ fL�.
Name: (owner) tinn GOils ArufA"am -V c. SUBDIVISION -Ave'l�j Po^� LOT # .5s:Z;
System Installer: —Vw.o 5 41�2Registration #
Basement with plumbing: ❑ Garage Ci(��umber of Bedro m�
Type of Water Supply: ❑q�Community L.d" Public ❑ Well Distance from well feet
System Type: ZS%e (kXxcA:og <jslr n ::03:D Types V and VI Systems expire in 5 years.
(In accordance with Table V a) TJOwner must contact Health Department 6 months prior to expiration for permit renewal.
this system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
PERMIT CONDITIONS
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
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 specifications for the sewa disposal system on the above captioned property.
Type of system: ❑
Conventional Other
Z.5% 2.�:wA;,,n St3km 19L9 Septic Tank:
12 G6 gallons Pump Tank: gallons
Subsurface
No. of
exact width of
depth of
Drainage Field
ditches
of each ditch G0 feet ditches
feet ditches 2 Z. inches
French Drain Required:
Linear feet
7
Authorized State AAe d j �64i✓� _" �� yS Date ! 2
—rT .
16-5-39007 (1)
16-5-39007 (6)
16-5-39007 (2)
16-5-39007 (3)
16-5-39007 (7) 16-5-39007 (8)
16-5-39007 (4)
16-5-39007 (5)
16-5-39007 (9)
16-5-39007 (11) 16.5-39007(12) 16-5-39007 (13) 16-5-39007 (14)
16-5-39007 (16)
16-5-39007 (10)
16-5-39007 (15)