OP RHTE# -500- al s 136 Harnett County Department of Public Health 2 0 7 3 9
PERMIT # 53 5`-1 Operation Permit
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0--New Installation tom--Septic Tank ❑ Repair h 4"itrification line ❑ Expansion
PROPERTY LOCATION: 1 L
Name: (owner) v lv~ 31 SUBDIVISION LOT #
System Installer: C C.(-1r4-cam- Registration #
Basement with plumbing. ❑ Garage 16- Number of Bedrooms
Type of Water Su ply: ❑ Community f~ Public ❑ Well Distance from w II 10J 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.
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This system has been installed in compliance with applicable North Carolina General'ttatutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
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PERMIT CONDITIONS:
I. 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 ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
Following are the specifications for the sewage disposal sy in on the above captioned property.
Type of system: ❑ Conventional iZ Other 1. ,t u Lll*' Septic Tank: ~k--1 gallons Pump Tank: gallons
Subsurface No. of act length width of depth of
Drainage Field ditches of each ditch a~ feet ditches feet ditches Pc~~ inches
French Drain Required: _ Linear feet
Authorized State
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