OP RHTE#~tZ - 11/1;YR Harnett County Department of Public Health
PERMIT # j7_ Operation Per it 2/Nitrification 2 2 2 9 5
L New Installation 12' Septic Tank Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: ' --il 6yz~jc4 /CA
Name: (owner) 344. ~ uo 5 SUBDIVISION LOT #
System Installer: 67a Registration # T
Basement with plumbing: ❑ umber of Be oms z
Type of Water Supply: ❑ Community Ivl Public Well Distance from well feet
System Type: I!W,, izz"91 Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must contact Health Department 6 montW-V
o expiration for permit renewal. Thi
s system has been installed in compliance with applicable North Carolina General Statutes, RuleVfor Sewage Treatment and Disposal, and all condition4of 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 ❑
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 sewage disposal system on the above captioned property.
Type of system:
❑ Conventional Other
o ° t}Zrh 9t5 . T !!!t 7 Septic Tank: 160 6
gallons Pump Tank: gallons
Subsurface
No. of
exact length T width of
depth of
Drainage Field
ditches
of each ditch 10 feet ditches
feet ditches inches
French Drain Required: Linear feet
Authorized State Age Date f 2
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Y
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12-5-29169R (1)
12-5-29169R (2)
12-5-29169R (3)
12-5-29169R (4) 12-5-29169R (5)
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12-5-29169R (6)
12-5-29169R (7)
12-5-29169R (8)
12-5-29169R (9) 12-5-29169R (10)
12-5-29169R (11)