OPHTE# 34 'd Harnett County Department of Public Health 2 0 9 2 8
PERMIT # Operation Permit
New Installation- J~IL Septic Tank Repair Nitrification Line 0 Expansion
PROPERTY LOCATION:
Name: (owner) r inn t tk /
C1 rVN1^ SUBDIVISION ~,cJ~ l ~r rs LOT #
System Installer: Q ) ftz r c (""t Registration #
Basement with plumbing: ❑ Garage i-Number of Bedrooms -3
Type of Water Supply: Commun'ty Public ❑ Well Distance from well J feet
System Type: Cllkvc ~ fy Types V and VI Systems expire in 5 years. J
(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 compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and
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PERMIT CONDITIONS:
1. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other
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and all conditions of the
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Permit and Construction Authorization.
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System shall perform in accordance with Rule .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.
Following are thTNo. cations for the sewage disposal system on the above captioned property.
Type of system:onventional ❑ Other
Subsurface of exact length
Drainage Field ditches of each ditch feet
French Drain Required: Linear feet
Septic Tank: -[Oj L) gallons Pump Tank: gallons
width of ` ~ depth of
ditches 2 feet ditches C)L/ ~S fir, inches
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Authorized State Agent ti l - L'~) Date to - U ' D
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