OP RHTE# 0 g -s-- Z~, C,_7 ( Harnett County Department of Public Health 21 16 8
PERMIT #S" Cs Operation Permit
New Installation [iKSeptic Tank ❑ Repair F" Nitrification Line ❑ Expansion
PROPERTY LOCATION: ✓i t 6,'f 4 /Pd.
Name: (owner) SUBDIVISION l u f ,A o r; ~ k~f LOT #
System Installer: /4 ja,ti Registration #
Basement with plumbing: ❑ Garage V umber of Bedrooms .s
Type of Water Supply: ❑ Community P public ❑ Well Distance from well feet
System Type: 7=7 G 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.
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 ❑ No
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
Following are the specifications for the sewsp disposal system on the above captioned property.
Type of system: ❑ Conventional i' Other Q.. k Y C Septic Tank: ~
Subsurface No. of gallons Pump Tank: gallons
exact length width of depth of
Drainage Field ditches of each ditch ~ro feet ditches feet ditches
inches
French Drain Required: Linear feet
11
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