OPHTE# 9Harnett County Department of Public Health 21113
PERMIT # 37S Operation Permit
New Installation Septic Tank ❑ Repair"X Nitrification Line ❑ Expansion
PROPERTY LOCATION: B,+ ~oNm YD
Name: (owner) Pussy )¢-r4 en._ SUBDIVISION m+o ~(aFaNfs, LOT #
System Installer: 0-vN:5 Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms 3
Type of Water Supply: ❑ Community ❑ Public Well Distance from well `cao feet t
System Type: `-1~T.. E-` !'s
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.
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PERMIT r0NnITfnNC-
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ NoA
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional l Other Ez--~-. Septic Tank: t (n (5a gallons Pump Tank: gallons
Subsurface No. of 3 exact length width of depth of
Drainage Field ditc of each ditch C, 6 feet ditches 3 feet ditches a inches
French Drain Required: bear feet
with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
Authorized State Agent ~ 4 15 Date 0