OPHTE# 01- 5`a, \hWf Harnett County Department of Public Health 19975
PERMfT # '2- Operation Permit
~ew Installation g Septic Tank El Repair 6 Nitrification Line O Expansion
PROPERTY LOCATION: \L>
Name: (owner) C6,,, n(\) V44r,S SUBDIVISION L,dRi, - r~2cyt3 k~ LOT # -LL
~
System Installer. Q C C ter Registration #
Basement with plumbing. ❑ Garage Number of Bedrooms
Type of Water Sup IT. jo Community Public ❑ Well Distance from well feet
System Type: 1 , Fit )2- t~ . ,1.( ~1 J)~ !~e 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.
Ibis system ha been installed in compliance with apoi abk North Carolina General Statutes, Rues for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and ConstnKtion Audrorintion.
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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:
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 ge disposal- rem on the above captioned property.
Type of system: ❑ Conventional Other Size of tank: Septic Tank: c" gallons Pump Tank: gallons
Subsurface No. of 1 exact length width of depth of
Drainage Field ditches 1 of each ditch -feet ditches '3_ feet ditches %~4 inches
French Drain Required: linear feet
Authorized State Agent Date 1'