OP RHTE# C7(,-S-1(-, IS~6t, Harnett County Department of Public Health 20813
PERMIT # 25 ) 9 Operation Permit
li~ New Installation Septic Tank ❑ Repair Nitrification line ❑ Expansion
PROPERTY LOCATION: 1-- -r.c_ V -o
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Name: (owner) Oc-7,, C-- , 1N C- SUBDIVISION Ga.T~.tic_ LOT # S ^
System Installer. 01T ``ssrt iL~a r,-.,co Registration #
Basement with plumbing: ❑ Garage -1~1, Number of Bedrooms
Type of Water Supply: ❑ Community .K Public ❑ Well Distance from well t OCR feet
System Type: ZrIT-b 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.
[his 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 and Construction Authorization.
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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 ❑ Nox
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
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Following are the speci
fications for the sewage disposal system on the above captioned property.
Type of system: ❑
Conventional Other Purse a P-Z. V Lc> ,,i
Septic Tank: l o coG
gallons Pump Tank: ►ocD0 gallons
Subsurface
No. of exact length
width of
depth of
Drainage Field
ditch of each ditch feet
ditches 3
feet ditches inches
French Drain Required:
_ ~ Uw feet
Authorized State Agent ANA Date '0141 0