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OP RHarnett County Department of Public Health 19670 PERMIT # 2t4C",5 Operation Permit New Installation -K Septic Tank ❑ RepairX Nitrification Line ❑ Expansion PROPERTY LOCATION: at D Name: (owner) R©D t-'L-C- SUBDIVISION a,►~') LOT # 4 System Installer. Registration # Basement with plumbing ❑ Garage ❑ ataetbeF-e~-~ Moot \O ~t.ayti Type of Water Supply: ❑ Community '9 Public ❑ Well Distance from well 100 feet System Type: :Z- V T" V and VI Systems expire in S years. (In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal. 11- >r> X111 - - "11- m campeance wim app Kaou N" Lamina 4ett" statutes, Auks Ior Sewage Treatment and Disposal, and all conditiom of dw Improvement Permit and tomtnxtion Audmnzation. 4. 3t s 4t;' ~ 34'~6e Pt2oPt~s6p P v r,p Ta I A2.8 ~E Ac~.E.P-t EP ( k.u o,~ Q- AQL-r` , PrRmrr rnunrrlnuc. 1. Performance: 11. Monitoring. III. Maintenance: System shall perform in accordance with Rule .1961. As required by Rule .1961. As required by Rule .1961. Other. IV. Operation: Subsurface system operator required.? Yes ❑ No ❑ If yes, see attached sheet for additional operation conditions, maintenance and reporting. V. Other. 1Cg'-0- `S S-1-an t O eJ~ P'W<LOVFrl TEL dCL~o `N7i bl LAcc ()1J JEPr G~P•~L ~~}u ~E1Ow ~R AOE. t`WE 'fMao 'rAu~ R~ O-ae7 HAs k" wp {rLV-~- . following are the specifications for the sewage disposal system on the above captioned property. Type of system: ❑ Conventional Other eo-ys, Z"L ~%&G -~eA„a,tSize of tank: Septic Tank: IOpO gallons Pump Tank: gallons Subsurface No. of exact length width of depth of Drainage field ditches of each ditch 65 feet ditches 3 feet ditches I1Z inches french Drain Reauired: e TFnn~r fa Authorized State Agent \V ' Q;5 Date