OPHTE#D7 500 133) > Harnett County Department of Public Health 19 8 81
PERMIT # Operation Permit
ECNew Installation -[;L Septic Tank ❑ Repaid ,E Nitrification Line ❑ Expansion
PROPERTY LKATION: N( d-1
Name: (owner) SUBDIVISION CA u RC l
~ Vj t LOT #
System Installer. t Registration
Basement with plumbing. ❑ Garage 67 Number of Bedrooms - 2
Type of Water pply: ❑ Commun Publi ❑ Well Distance from well S feet
System Type: n r a, r , h Types Y 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.
This system has been installed in compliance with i(&e Ilorth Carohna General Statures, Rules for Sew Treatment and Disposal, and all cordiam or the Improvement Permit and Construow Authorzaaon
1 '21
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1-4
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PERMIT CONDITIONS:
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 sewage disposals tem on the above captioned property.
Type of system: ❑ Conventional ~ Other _
,ys ; y Size of tank: Se tic Tank: 0,:,3
Subsurface No. of p gallons Pump Tank: J ~ z> gallons
exact length width of depth of
Drainage Field ditches of each ditch feet ditches
feet ditches inches
French Drain Required: linear feet
r
Authorized State Agent ` Date (-7v
1