OPHTE# ~g - r-kX-, 3-3, Harnett County Department of Public Health 21 2 7 2
PERMIT # Operation Permit
V New Installation Imo' Septlc c Tank ❑ Repair Nitrification Line ❑ Expansion
PROPERTY LOCATIO: : cra -4j- 9j.
Name: (owner) Lt ~s SUBDIVISION P,, J LOT # -/b
System Installer: Registration #
Basement with plumbing: ❑ Garage VNumber of Bedrooms s
Type of Water Supply: ❑ Community 2e Public ❑ Well Distance from well feet
System Type: ni C- 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.
this system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Di
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DCDYIT fD\IDITIDIIf
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the Improvement Permit and Construction Authorization.
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:
V. Other.
Following are the specifications for the sewa disposal system o t e above captioned property.
Type of system: ❑ Conventional Other E ~ !ia ~-J
Subsurface No. of exact length
Drainage Field ditches of each ditch 5- feet
Septic Tank: a/ `a gallons Pump Tank: gallons
width of depth of
ditches 3 feet ditches --36 inches
French Drain Required: Linear feet
Authorized State Agen ' ' . Date c~ /tl /~7/'7Cfd
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