OPHTE# /I.-';- 91- Harnett County Department of Public Health
PERMIT # 2&!i,--13 Operation Permit 2 2 0 6 4
New Installation I~ Septic Tank L2' Nitrification Line ❑ Repair ❑ Expansion
Name: (owner) 0 of F"
System Installer:
Basement with plumbing: ❑ Garage C
Type of Water Supply: ❑ Community G
System Type:
(In accordance with Table V a)
PROPERTY LOCATION: 609 17v!!j- &IeA~ /400
SUBDIVISION LOT # 0A
Registration #
umber of Bedrooms
Public ❑ Well Distance from well feet
7t_4eyeX7 C- Types V and VI Systems expire in 5 years.
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, Rule~f8fi Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
1. Performance: System shall perform in accordance with Rule .1961. 5L MO S t3~ A-->
~ <l cr ~~y y2 ~i
II. Monitoring: As required by Rule .1961
III. Maintenance: As required by Rule .1961. Other:
IV. Operation:
V. Other:
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
❑ D-Box ❑ Pump ❑ Alarm ❑ H20Line ❑ PWR Line
Following are the specifications for the sews disposal system on the above captioned property.
,ge Type of system: ❑ Conventional Other Z,'501,9 r s _ Septic Tank: 0 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch f feet ditches feet ditches 22- inches
French Drain Required: Linear feet
Authorized State A ent Date /
11-5-26895 (1) 11-5-26895 (2) 11-5-26895 (3)
P-2 i/
11-5-26895(4) 11-5-26895(5)
11-5-26895 (6)
11-5-26895 (7)
11-5-26895 (8)
11-5-26895 (9)
11-5-26895 (10)
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11-5-26895 (11)
11-5-26895 (12)
11-5-26895 (13)
11-5-26895 (14)
11-5-26895 (15)
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11-5-26895 (1)
11-5-26895 (2) 11-5-26895 (3)
11-5-26895 (4)
11-5-26895 (5)
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11-5-26895 (6)
11-5-26895 (7) 11-5-26895 (8)
11-5-26895 (9)
11-5-26895 (10)
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F
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11-5-26895 (11)
11-5-26895 (12) 11-5-26895 (13)
11-5-26895 (14)
11-5-26895 (15)