OP RHTE# 0` 5-00- U,31 K Harnett County Department of Public Health 2 0 7 2 7
PERMIT # a 5 3 Operation Permit
/ _New Installatiot~ Septic Tank ❑ Repair Nitrification Line ❑ Expansion
tV/ ~~PROPERT'l LOCATION: Z
Name: (owner) SUBDIVISION Gt/~~clJ~,l✓L LOT # g5_
System Installer: i /t r Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms _ 3
Type of Water Suppl : ❑ Community ~L Public ❑ Well Distance from well O] feet
System Type: - 2 rt L ja 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 rerrAwaal~-X
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 Construction Authorization.
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PERMIT CONDITIONS:
1. Performance: System shall perform in accordance with Rule .1961. L'J2'
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.
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Following are the specifications for the sews a disposal syst on the above captioned property.
Type of system: ❑ Conventional Other r. 2 r (A/ Septic Tank: gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch -l= feet ditches feet ditches inches
French Drain Required: Linear feet
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