OPHTE# 1 / a ~v3 Harnett County Department of Public Health
PERMIT # 9, ~03 YJ_ Operation Permit 21 8 4 9
New Installation [R"~Sptic Tank 0'_ Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:r ,
Name: (owner) Cant4- SUBDIVISION LOT #
System Installer: Registration #
Basement with plumbing: ❑ Garage Pumber of Bedrooms 3
Type of Water Supply: ❑ Community ublic ❑ Well Distance from well feet
System Type: La~ G_ 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
SZa
F
f
~Q 1 ~ t tl
s r
8 F
~ r
rERrui LONLA tuNS:
1. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No R~
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV Operation:
V. Other:
❑
D-Box
El
Following are the specifications for the
Type of system:
El Conventional
Subsurface
No. of
Drainage Field
ditches
Pump El Alarm El
sews disposal system on the above captioned property.
Other E-Z -"/d U' Septic Tank: I WO
exact length e~ width of
f of each ditch /8 o feet ditches
H20Line ❑ PWR Line
gallons Pump Tank: gallons
depth of
feet ditches °2`r'--30 inches
French Drain Required: Linear feet1~
Authorized State Agent 4~~ a~ . Date &/-Vv'~6"°'/
,,I-S ~ R YV,7