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OPHTE 5�'i Harnett County Department of Public Health PERMIT # 2-115 Operation Permit 22533 New Installation '�q Septic Tank Nitrification Line ❑ Repair ❑ Expansion PROPERTY LOCATION: O ©cs Name: (owner) CC sv5"s 2yG'S� o �,3 SUBDIVISION LOT # System Installer: Q) i ,-!- S �.�c,rc �� Registration # Basement with plumbing: ❑ Garage Number of Bedrooms Type of Water Supply: ❑ Communi Public El Well Distance from well 100 feet System Type: 1 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. 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 P, 's a _ E 53 t �lous� T 5—j PERMIT CUNDITIUNS: I. Performance: System shall perform in accordance with Rule .1961. II. Monitoring: As required by Rule .1961. 111. 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 cap O*,ed property. Type of system: ❑ Conventional \I Other �V 'y* - R 'VG 'E �-OW Septic Tank: VOOO gallons Pump Tank: tt ' 00 gallons Subsurface No. of exact length width of depth of Drainage Field d ci heess —' � of each ditch ��d feet ditches feet ditches inches French Drain Reauired: — ' ar"feet Authorized State Agent tot; S Date 11 I t3 I �,- 5 a(�56 �