OPHTE# k- ~?0 Harnett County Department of Public Health
PERMIT # a ~S° f z Operation Permit 2 2 0 2 7
Tank Y" Nitrification Line ❑ Repair ❑ Expansion
VNew Installation Setic
PROPERTY LOCATION:
Name: (owner) OAC c 1 SUBDIVISION / e^a r c e LOT #
System Installer: 7kco 111lt l ,JAj A_9 Registration #
Basement with plumbing: ❑ Garage C" Number of Bedrooms y
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: 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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PERMIT CONDITIONS:
1. Pertormance: 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 01
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 sews cisposal~jstem on he above captioned property.
Type of system: ❑ Conventional Other t' 2- t~ a vJ Septic Tank: /030 gallons Pump Tank: gallons
Subsurface No. of exact length t1 width of depth of
Drainage Field ditches of each ditch 7 feet ditches feet ditches inches
French Drain Required: Linear feet
Authorized State Agen a ~i Date
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