OPHTE# //-5_'-nz7_7 Harnett County Department of Public Health
PERMIT # d-~~oy Operation - Permit 2 2 0 2 6
Z New Installation IUJ Se tic Tank Lei' Nitrification Line ❑ Repair ❑ Expansior
_ PROPERTY LOCATION: t v`f kk
Name: (owner) Cs e acct yr _ SUBDIVISION LOT #
System Installer: e Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms _,7
Type of Water Supply: ❑ Community Lr Public ❑ Well Distance from well feet
System Type: J_2r 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
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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
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
❑ D-Box ❑ Pump ❑ Alarm ❑ H20Line ❑ PWR Line
Following are the specifications for the sewa disposal system on the ove captioned property.
Type of system: El Conventional Other ~ Septic Tank: C~ 6 gallons Pump Tank: gallons
Subsurface No. of / exact length width of depth of
Drainage Field ditches 7 of each ditch (OP feet ditches 3 feet ditches 0C) l~ inches
French Drain Required: Linear feet
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This loaf of tiro chips is from the Fuel Grade location and meets the Nc specaficatia" as
sr,, ,i `„F -avafiva Wastewater system cpproval IWWS-2002-03R for tire chip
Substrlwtion for Rock Aggregrate In Nitrification Fields.