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OP4c 7 RR 1 'A HTE# O`NHarnett County Department of Public Health 2 0 7 9 8 PERMIT #Operation Permit New Installation '~Eq Septic Tank ❑ Repair, Nitrification Line ❑ Expansion PROPERTY LOCATION: Name: (owner) 7~S P,~ S u K\--« SUBDIVISION Ge-&,ju- ~cZ~t~cE LOT # -1 System Installer. L- Amy S~QC Registration # Basement with plumbing: ❑ Garage Number of Bedrooms 3 Type of Water Supply: ❑ Community Public ❑ Well Distance from well tt) O feet Y 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 system nas peen mstanea in compoance wim apphcanle North laroima General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization h R-bA ( ~GtAC?bq l ~ _ 1 C a'~6 ~S 8 SLj .x ~8" V kN /GN T t~ 1'y0 Go" ~~w r:ntvi wnut1lUn : 1. Performance: System shall perform in accordance with Rule .1961. II. 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 Following are the specifications for the sewage disposal system on the above captioned property. Type of system: ❑ Conventional -K Other 1 0- e- Ct PS Septic Tank: 100 0 gallons Pump Tank: gallons Subsurface No. of exact length width of depth of Drainage Field ditches of each ditch ~ feet ditches 3 feet ditches 17 inches French Drain Reauired: a of Authorized State Agent E. - ~ (,-5 Date This load of fire chips is from the Feat Grade locction and meets the %!c specificatlon qs f(q;2d In Innovativ© Wastewater system approval IWWS-2002.03R !of HIS chip SilbWWi" for Rock Aipg.aae In NNrRkotlen FfeldL