OP RRHTE# O i - Harnett County Department of Public Health 21 1 3 8
PERMIT # r6 Operation Permit
New Installation Septic Tank 11 Repair ❑~NitrificaTion Line ❑ Expansion
p PROPERTY LOCATION: i5d.
Name: (owner) rte +4
n SUBDIVISION d-k All4 Crre~~~ LOT # ~
System Installer: 14 s k - e 0.st Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: 7? 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.
uus system nas peen mstauea in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the
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PERMIT CONDITIONS:
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Permit and Construction Authorization.
Performance: System shall perform in accordance with Rule .1961.
Monitoring: As required by Rule .1961.
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:
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V. Other. D-X t, L, ,e. O K e e I c1. cr
Following are the ifications for the sewage disposal system on the above captioned property.
Type of system: spConventional ❑ Other
Subsurface No. of exact length Q
Drainage Field ditches 3 of each ditch 8 0 feet
French Drain Reauired:\ 'knoar hmet
wACE2t-.NG c>+Ec zw
Ou s"J qt o
Septic Tank: / 53~ 0 O gallons Pump Tank:
width of depth of
ditches -..J- feet ditches W4 3 G
gallons
inches
Authorized State Agent Date
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Vol i
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