OPHTE #) " > -2T-
Harnett County
Department of
Public Health
PERMIT # 272-1 1
Operation Permit '
,I" w Installation Seotic Tank 2 Nitrification Line
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2 2 4 9 7
❑ Repair ❑ Expansion
PROPERTY LOCATION: -o�11.13 r &42' v- 4(L
Name: (owner) o - "Is SUBDIVISION LOT # Z—
System Installer: A OCEx�' Registration #
Basement with plumbing: ❑ Garage �,rMumber of Bedrooms 3
Type of Water Supply: ❑ Community L Public ❑ Well Distance from well feet
System Type: �S e — r {T"— t pes 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.
This system has been installed in
with aoolicable 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 CONf3}TtM
I. Performance:
II. Monitoring:
III. Maintenance:
N
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System shall perform in accordance with Rue .1961.
As required by Rule .1961.
As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
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IV. Operation:
V. Other:
❑ D -Box ❑ Pump ❑ Alarm ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sewa ge disposal system on the above captioned property.
Type of system: ❑ Conventional Eff Other : �— Septic Tank: 1 gallons Pump Tank: gallons
Subsurface No. of exact length t width of depth of
Drainage Field ditches of each ditch 100 feet ditches -� feet ditches 4- inches
French Drain Required: Linear feet
Authorized State A2P =t .
Date
12 -5 -29826 (2) 12 -5 -29826 (3) 12 -5 -29826 (4) 12 -5 -29826 (5) 12 -5 -29826 (6)
12 -5 -29826 (7) 12 -5 -29826 (1)