OPHTE# c*- ZZ~6 Harnett County Department of Public Health
PERMIT # Operation Permit 21 9 7 9
New Installation X Septic Tank X Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LKATION:
Name: (owner) O Ng- 1 ocr SUBDIVISION '2)s_a..PQ_p We~csvS LOT # ►10
System Installer: bg,c~~,-Ctx~~i Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms
Type of Water Supply: ❑ Community -14 Public ❑ Well Distance from well t®O feet
System Type: Types V and VI Systems expire in 5 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 General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
9 ~..~[p N'S S
~ DfZ ~V E
Sa22t 1
PERMIT CONDITIONS:
1. Performance: System shall perform in accordance with Rule .1961.
II. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No X
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation: c»V~SttlN ~e,P Focz_ A\ _P",
V. Other: SvaoL:t U'E l+vs~D.L:LfD 124 cP2opty_. SQ,e-'~G. 7 Sows
❑ D-Box ❑ Pump ❑ Alarm ❑ H20Line ❑ PWR Line
Following are the specifications for the sewage disposa system on the above ca tioned property.
Type of system: El Conventional X Other v fne 7--2I. Septic Tank: ! 00(!D gallons Pump Tank: kbO® gallons
Subsurface No. of exact length width of depth of
Drainage Field ditche3-- of each ditch 3CX-) feet ditches feet ditches 06
inches
French Drain Reauired: "linear. e
Authorized State Avent_ ~ 11 33 5 Date