OPHTE# 05-s-aar73 Harnett County Department of Public Health 2 0 7 2 0
PERMIT # ~s'S Y Operation Permit
1 New Installation Ek SLticcTannkK rm❑ Repair [nitrification Line ❑ Expansion
PROPERTY LOCATION: ~
Name: (owner) Q~.1e-} ~v~ tirrw ! SUBDIVISION l cad 5 LOT # 1K7
System Installer. O . lefo Registration #
Basement with plumbing: El Garage El Number of Bedrooms
Type of Water Supply: ❑ Community [[Public ❑ Well Distance from well feet
System Type: Cr- 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 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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PERMIT CONDITIONS:
1. Performance:
II. Monitoring:
111. Maintenance:
System shall perform in accordance with Rule .1961
As required by Rule .1961.
As required by Rule .1961. Other
IV. Operation:
V. Other.
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
Following are the specifications for the sewa sposal syste op e above captioned property.
Type of system: ❑ Conventional Other F o w
Subsurface No. of / exact length
Drainage field ditches / of each ditch 150 feet
French Drain Required: Linear feet
Septic Tank: /0 0 (3 gallons Pump Tank: gallons
width of depth of
ditches -7 feet ditches (e, inches
Z'11 Authorized State Agen L l; /~J Date Z ~ l ~4 b5'
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