OP RRRH T E # Q'-1-5a2-15jg2.Q,, Harnett County Department of Public Health 21 Q 9 7
PERMIT # Operation Permit
New Installation "'K Septic Tank ❑ Repair Nitrification Line ❑ Expansion
PROPERTY LOCATION: _M i • Os-~~E G~,c.s~c
Name: (owner) Cc+nGA4aWo ES SUBDIVISION LOT #
System Installer: t-wui-ji Registration #
Basement with plumbing. ❑ Garage ❑ Number of Bedrooms
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well sb 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.
]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.
11. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ No
If yes, see attached sheet for additional operation cc
IV. Operation:
V. Other.
maintenance and reporting.
Following are the specifications for the sewage disposal system on/+ the above c1a,~ptioned property.
Type of system: ❑ Conventional X Other Quwp~~ ti t_I%0- `c Gtt-664- Septic Tank: t060 gallons Pump Tank: Ic~>dd gallons
Subsurface No. exact length width of depth of
Drainage Field ditches \ of each ditch t b feet ditches 3 feet ditches inches
French Drain Required:.. e~ 40
Authorized State Agent Date 111►0