OP RHTE# Harnett County Department of Public Health
PERMIT # Zbgz%,~ Operation Pe ' it 2 2 0 7 0
2' 2 New Installation c Tank /Nitrification Line ❑ Reaair ❑ Exoansion
_ PROPERTY LOCATION: YA,/-702~ 1 9 , . r~
Name: (owner) K)K,1_ 5iA_ 1,51 SUBDIVISION LOT #
System Installer: Kcj~sAtete_ Registration #
Basement with plumbing: ❑ Garage D Shimber Be om
Type of Water Supply: ❑ Community Id Public - We Distance from well ' rN 4 feet
System Type: 11 G Types V and VI Systems expire in 5 years.
(In accordance with Table V a) /F Owner must cot tact 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.
I
PERMIT CONDITIONS: v _ - f&i1V 1 „flip
I. 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 sews disposal system on the above captioned property
Type of system: ❑ Conventional Other i"% iZ90 a -aZ-4r fiat Septic Tank: 12c(~ gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch /00 feet ditches 3 feet ditches 2d inches
French Drain Required: Linear feet
Authorized State en _ ~ Date I,-) ~ 11
t
,
,
11-5-26198R (1) 11-5-26198R (2) 11-5-26198R (3) 11-5-26198R (4) 11-5-26198R (5)
11-5-26198R (11)
11-5-26198R (12)