OPHTE# 0c) - 3- SO`a Harnett County Department of Public Health 21 0 7 2
PERMIT # X50 Operation Permit
X New Installation Septic Tank ❑ Repair Nitrification Line ❑ Expansion
PROPERTY LOCATION:
Name: (owner) Ceu~u I--A-0 dE.vf-joe r.E.r SUBDIVISION ~oct-~ OQ,~-s LOT
System Installer: O . C , G-crvE.ct- Registration #
Basement with plumbing. ❑ Garage Number of Bedrooms
Type of Water Supply: ❑ Community Public ❑ Well Distance from well ICIP feet
System Type: b 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.
qxa a 1!- UCen mxaneo in
with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the
Permit and Construction Authorization.
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PERMIT CONDITIONS:
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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 ❑ Nox
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other. -NN." A LAtirrs GiGC'X.10 $'Y 0~ Uw P ~+Lq t 01 sUS~7 U, Sty ya 6
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Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional Other Qu ~ u~c~ t't C-tRs*'e6L
Septic Tank: to00 gallons Pump Tank: LCO<d gallons
Subsurface No. of--_\ exact length width of depth of
Drainage Field ditches of each ditch a Op feet ditches feet ditches I aLi
French Drain Reou-i ~ _ inches
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Authorized State Agent ~5 Date