OPHTE#M-S5 Harnett County Department of Public Health 21 10 8
PERMIT # Operation Permit
New Installation X Septic Tank 0 Repair; Nitrification Line El Expansion
PROPERTY LOCATION: 1 to c,o,5 Q=D
Name: (owner) ? aNc, enGGt4,~ SUBDIVISION CPCio~-~~~. OAv~ LOT # ~0_
System Installer. WK-rir-A 7:o,.4 CE-5 Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms
Type of Water Supply: ❑ Community Public ❑ Well Distance from well ► C o 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.
u >r>«m ❑a ueen imianeo in
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:
19
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 ❑ No
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: X Conventional ❑ Other
Subsurface No. of exact length _
Drainage Field tches of each ditch 7d feet
French Drain Reauired: t,,,,.
Authorized State
Septic Tank: 1000 gallons Pump Tank gallons
width of depth of
ditches 3 feet ditches A4 inches
Date
s,
77
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