OP (2)HTE# 15-5-X'i07 Harnett County Department of Public Health 23840
PERMIT # `ZOperation Permit
nl New Installation X Septic Tank )< Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: Prctiivs Q�
Name: (owner) C,r-ao ,%Tori )An� C.5 SUBDIVISION 5-<<-�o rJ LOT # 1
System Installer. P111 9 PS $p,c N A o E Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms Zb I
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 100 feet
System Type: =Lam Types V and A Systems expire in S 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 both Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
PERMIT CONDITIONS
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
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PERMIT
ry
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ Max
If yes, see attached sheet for additional operation a
maintenance and reporting.
❑
D -Box
❑ Pump ❑ Alarm ❑
H2OLine ❑ PAIR Line
following are the
specifications for
the sewage disposal system on the above captio ed prap�t)'
Type of system:
❑ Conventional
Other �` C,,e-, L tQ'r1oP Septic Tank: t b
gallons Pump Tank: s 0`60 gallons
Subsurface
No. of
exact length width of
depth of
Drainage Field
ditches of each ditch 300 feet ditches '3
feet ditches inches
French Drain Required:
Linear feet
Authorized State Agent f7e✓\,6 Date ii 1 -if' 15—
15_ 5=5(GC7 ]