OP see folder Cameron Family DentistryHTE# c~-r:1-- ~I ) Harnett County Department of Public Health 21253
PERMIT # Operation Permit
New Installation ~N Septic Tank ❑ Repair X Nitrification Line ❑ Expansion
PROPERTY LOCATION: NC' rlwy 3"A
Name: (owner) Z Ky \a E G p,~o c>s ~s SUBDIVISION coc.~ 1 >~P6 E LOT # 10(,
System Installer: APP. $tacxx,a _ Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms + 00k'~' C-4-,t,cPt- %e*,<.F- CAc" 5-, 4vv,ct- - 5ag9P~~
Type of Water Supply: ❑ Community 'X Public ❑ Well Distance from well tC)o feet
System Type: Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
Ilus system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
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1. Performance: System shall perform in accordance with Rule .1961.
II. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes)< No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation: Ec-v Irv To Q Sv„YQ LEo 9En. q; C-00"IN ~t 1 E Co N'C cz C
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V. Other. W►~Ga L,.,E CrL-orsF.S P- bus- 1~ Agov S>oacrc S„pptry L.aN(.
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: X Conventional ❑ Other
Subsurface No. of exact length
Drainage Field ditches 3 of each ditch -7 feet
Septic Tank: aaOO gallons Pump Tank: gallons
width of depth of
ditches 3 feet ditches -)4 - 4$ inches
French Drain Required: Linear feet
Authorized State Agent 7 ~c>~ Date QJ-d to