OPHTE# ,&S '330 Harnett County Department of Public Health 24510
PERMIT # 2$$$1 Operation Permit
New Installation 10 Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LO[ATION: 997 YZ
Name: (owner) SUBDIVISION LOT # L
System Installer: -ZONroz Registration #
Basement with plumbing: ❑ Garage ❑ umber of Bedrooms `
Type of Water Supply: EJ Community Id Public ❑ Well Distance from well feet
System Type:° es V and VI Systems expire in S years.
(In accordance with Table V a) iF Owner must contact ealth Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Carolina General Sutures, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Coni Authorization
PERMIT CONDITIONS
I. Performance:
Il. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
�D
1-0
I6
V
yZ
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 sewage disposal system on the above captioned property.
Type of system: ❑ Conventional 19 Other ZS% /7el)GrCUL Septic Tank: 000 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches ) of each ditch 1115- feet ditches 3 feet ditches f 8 inches
French Drain Required: Linear feet
Authorized State Apfrr iTh /�rA%Ii4�s �µsDate %—� y
16-5-38530 (1)
16-5-38530 (2)
16-5-36530 (3)
16-5-38530 (4)
16-5-38530 (5)
16-5-38530 (6)
16-5-38530 (7)
16-5-38530 (8)
16-5-38530 (9)
16-5-38530 (10)