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NTE# D7-:5--- 17307 Harnett County Department of Public Health 19 51 2
PERMIT # o?37~ Operation Permit
Ill New Installation 0 "'Septic Tank ❑ Repair Nitrification line ❑ Expansion
PROPERTY LOCATION: ,/w,7 /Z4,1 s c.luI3 wy)
Name: (owner) S"rt"G r4--.,14- SUBDIVISION
S stem Installer. -,I- LOT # / 9
Y Registration #
Basement with plumbing. El Garage 12 "'Public of Bedrooms
Type of Water Supply: ❑ Community 12 Public ❑ Well Distance from well feet
System Type: Zvi 2r r s o to S►s -T szr Cr- Types Y and YI Systems expire in S years.
(In accordance with Table Y a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
ihts system has been installed in compiance with *Ocable North farokna General Statutes, Mules for Sew Treatment and Disposal, and all cotchtiom of die bnproremem Vertnit and fomtrumon Autimutiom
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1. Performance:
II. 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
Y. Other. W rry L-4 N 6 E Qo.+EO L: r E e.~ ~F,ES~ ~7 s Fv o To~r4soec~r
Following are the specifications for the sew disposal system on the above captioned property.
Type of system: ❑ Conventional LJ Other Size of tank: Septic Tank: Z -7-D gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage field ditches Z of each ditch IZo feet ditches
feet ditches ?E>-;'/ 8 inches
french Drain Required: - linear feet
Authorized State A nt Date g-2P o J