OPHTE# ocl-~~30--1-3 Harnett County Department of Public Health 21 2 3 3
PERMIT #Operation Permit
New Installation X Septic Tank ❑ Repair'A Nitrification Line ❑ Expansion
PROPERTY LOCATION: \-Ji 9.r C-o
Name: (owner) ~.A~aEtr. ; • SUBDIVISION LOT # a.~
System Installer. Registration #
Basement with plumbing. ❑ Garage Number of Bedrooms
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 1 CC-) feet
System Type: "-Ub Types 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.
INS system has been installed m .compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
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1. Performance: System shall perform in accordance with Rule .1961.
11. 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.
Following are the s ecifications for the sewage disposal system on the above captioned property.
Type of system: Conventional ❑ Other
Subsurface No. of exact length
Drainage Field ditches ach ditch -75 feet
French Drain Required: _ Lilrar
Septic Tank: 1000 gallons Pump Tank: gallons
width of depth of
ditches feet ditches c~j_ inches
Authorized State Agent \ - `\\~,\\~5 Date i
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