OPHTE# O~-sr Harnett County Department of Public Health 2 0 8 0 6
PERMIT # a o°18 Clperatlon Permit
New Installation X Septic Tank ❑ RepairX Nitrification Line ❑ Expansion
PROPERTY LOCATION: Name: (owner) NOwEi>. ~o,,,o SUBDIVISION LOT # al
System Installer: Registration #
Basement with plumbing: ❑ Garage 'A Number of Bedrooms
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well ~o cs 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.
ims system nas peen 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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I. 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 \.aN¢3G~* ~ 0- °1 \1 0`1 S-~) P,_,rt I&E C-*g4Vo
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional '1~ Other Pv~.e`Ce EZ-Septic Tank: tOOa gallons Pump Tank: t000 gallons
Subsurface No. of exact length width of depth of
Drainage field ditches 21 of each ditch % '-A-o feet ditches _ feet ditches s:Z- inrhot
rent ram Required: linear feet
Authorized State Agen6;' ` /C e'w-` Date I ° /"5-/2
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