OPHTE# 09- s-a►~~ Harnett County Department of Public Health 2 0 5 5 5
PERMIT # a5'310 Operation Permit
New Installation X Septic Tank ❑ RepairX Nitrification Line ❑ Expansion
PROPERTY LOCATION: rl►cao`Toyc6ct
Name: (owner) SS HOr►P,S 1R w~N SUBDIVISION Rcs 4ooF C1w-9-t.c..., LOT #
System Installer: Q'C.> S'a.Nc..X-tia-"4d Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms Lk
Type of Water Supply: ❑ Community ❑ Public N Well Distance from well fC)4 feet
System Type: .S f b &X%1n%' 6 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 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.
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PERMIT Midn1TU1tlt.
1. Performance:
II. Monitoring:
III. Maintenance:
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other
IV. Operation:
V. Other.
Subsurface system operator required? Yes ❑ NoXI
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: Conventional ❑ Other
Subsurface No. of exact length
Drainage Field ditches ~L of each ditch s Oa feet
French Drain Required, 1bur feet
Septic Tank: 100(j gallons Pump Tank: gallons
width of depth of
ditches 3 feet ditches inches
Authorized State Agent Q,5 Date
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