OP RHTE# /,o -,s=o2V.s-`o K Harnett County Department of Public Health
PERMIT # oZ~ l Y6 Operation Permit Z Nitrification Ed New Installation 21 Septic Tank ® Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:
Name: (owner) S4--r- 7kd,,,J- SUBDIVISION C An LOT # 8
System Installer: Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms -3
Type of Water Supply: ❑ Community VPublic ❑ Well Distance from well feet
System Type:ZZ ji 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.
finis system nas peen inscanea in compuance wim appucanie north Laronna t,enerai statutes, Rules for )ewage Ireatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
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PERMIT CONDITIONS:
1. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No 12/
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
❑ D-Box ❑ Pump ❑ Alarm ❑ H201-ine ❑ PWR Line
Following are the specifications for the seewwap disposal system on the a0ve captioned property.
Type of system: ❑ Conventional Ltd' Other (v"' J- 4 C.1\(3,- . lz-- Septic Tank: ~ gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch feet ditches 3 feet ditches A q°36 inches
trench Drain Required:
Linear feet
Authorized State Agent
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Date l~~12
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