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OPHTE#Qn-5-a1-) 34 Harnett County Department of Public Health 20551 PERMIT # A~~ Operation Permit New Installation X Septic Tank ❑ Repair Nitrification Line ❑ Expansion PROPERTY LOCATION: -T;ns C.~an,N Name: (owner) ~o sue?. ~>-sap SUBDIVISION LOT # System Installer: M t wc- 'Q_ r, Registration # Basement with plumbing: ❑ Garage ❑ Number of Bedrooms Type of Water Supply: ❑ Community >k Public ❑ Well Distance from well ~o© feet System Type: 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. ims sptem nas oeen mssaneo in compoance wim appinwe Norm laroona beneral Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorisation. a'b-c6d~ ~ CAN V 't^..f"+tbNPH Q \ ~rLrcq C `f 1 52 tO.S'a rcnrm WRUI M. 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 ❑ N If yes, see attached sheet for additional operation conditions, maintenance and reporting. IV. Operation: V. Other. Following are the specifications for the sewage disposal system on the above captioned property. Type of system: Conventional ❑ Other Subsurface o. o exact length Drainage Field ditches of each ditch A 15 feet French Drain Reauired: r fna7~ Septic Tank: BOO gallons Pump Tank: _ width of depth of ditches 3_ feet ditches _ gallons inches Authorized State Agent ~~~~~\\\\R Date f a 1 t a. 'f c~ ~ ~ _ ,rY ~ <''z rya ~ l ;m. ~ ~ .,roe 1 F ~ c s. ~ - - R - ,may ~ " ~ 1T P rE ; ' Ior t = if t } u F 'F 1 } d y .y y I m•~t dsf ~1 tF n1 ~~N. h f qy ~Y - r._~ ~ t:~ 'TR kA;