OP RHTE#o9 -S-2Z1 Harnett County Department of Public Health 2 0 8 8 9
PERMIT # Z 5q `f 1Operation Permit
New Installation 12 Septic Tank ❑ Repair [21 Nitrification Lin DExpansion
PROPERTY LOCATION- s 3
Name: (owner) s s SUBDIVISION LOT #
System Installer: ,,.r~,c Registration
Basement with plumbing: ❑ Garage ❑ umber of Bedrooms
Type of Water Supply: El Community L Public ❑ Well Distance from ell feet
System Type:~25~/0~1)Li I S}, ,z 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 r ewal.
This system has been installed in
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with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the
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PERMIT CONDITIONS:
1. Performance:
II. Monitoring:
111. Maintenance:
1)
Permit and Constriction Authorization.
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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 sews disposal system on the above captioned property.
Type of system: ❑ Conventional [ Other 2 %,lam 70J 54 5, Septic Tank: /000 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch / 7 0 feet ditches 3 feet ditches 1 inches
French Drain Required: linear feet
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Authorized State A~et`It Date /D - z 3 - o j
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