OP RHTE# 07 - s- I7Y671,7 Harnett County Department of Public Health 19 8 5 3
PERMIT # 43Bco Operation Permit
IQ New Installation Septic Tank El Repair Z Nitrification line ❑ Expansion
PROPERTY LOCATION:~iy25~ C~
Name: (owner),cs;•,,~ SUBDIVISION f,~ LOT # 53
System Installer. Registration #
Basement with plumbing ❑ Garage mber of Bedrooms ~i-
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: G bZ Types Y and YI Systems expire in 5 years.
(In accordance with table Y al Owner mu contact Health Department 6 months prior to expiration for permit renewal.
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Y. Other:
Following are the specifications for the disposal system on the above captioned property.
Type of system: El Conventional 710ther JZ~p ) VCf- Size of tank: Septic Tank: / 6 0 D gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches ' of each ditch Z N b feet ditches
French Drain Required: linear feet feet ditches_ inches
Authorized State AgDate Z Zo ae
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: