OP RHTE# n5 -5-- 118S~/z Harnett County Department of Public Health 19841
PERMIT # 2 3 -2 -7 -7 Operation ermit
2 --"New Installation Id Septic Tank ❑ Repair ff Nitrification Line ❑ Expansion
PROPERTY LOCATION: _se' D
Name: (owner) XY 7 L SUBDIVISION G3e,,,~le., LOT #
94 System Installer. t,~ Registration #
Basement with plumbing. ❑ Gara a N ber of Bedrooms 3
Type of Water Supply: ❑ Community ld Public ❑ Well Distance from well feet
System Type: / Sc s +~t._ Q~ zr CV.,._..h-t 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.
11-1 ,Preen HAS DM ima wa m compoance witn appoc" North tarotina General Statutes, Rrdes for Sewage Treatment and
and aN condition of the Improvement Permit and (onuruction Authorization
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PERMIT (ONI)MAK-
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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 ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
following are the specifications for the sew disposal system on the above captioned property.
Type of system: ❑ Conventional Other 7S'~b~2 Size of tank: Septic Tank: /DC-6 gallons Pump Tank: I o e) v gallons
Subsurface No. of exact length width of depth of
Drainage field ditches _ of each ditch 30v feet ditches 3 feet ditches 24 inches
French Drain Required: linear feet
44
Authorized State Date 1 S ID8