OPHTE# o'- S00\ 0 1 Harnett County Department of Public Health 19898
PERMIT # -f Operation Permit
New Installation -9-- Septic Tank O Repair-l Nitrification line O Expansion
PROPERTY 10U1TI0N: 'R G a
Name: (owner) `t° r4- SumvisI0N Lc)-.r-J `J P~ c- JOT #
System Installer. (G ~Ot Jf~ Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms
Type of Water Community Public ❑ Well Oist fr
anc om y II ~0 feet
System Type: V L~ I r 1-f I Types V and VI Systems expire in S years.
(In accordance with Table Y a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
tors system hb been msUW in mplivo with appkcAle North C"na Gew;J Stables, R ks for Sewage Trutmw and Di "W, aW al conditions of the Improvement Permit Cw&nKbon Auth 6uvon
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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 f
If yes, see attached sheet for additional operation ca
IV. Operation:
maintenance and reporting.
V. Other.
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Following are the specifications for the sewage dispos system on the bove captioned property.
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Type of system: ❑
Conventional ~j Other
u . t h ~LA Size of tank: Septic Tank:
U60-0 gallons Pump Tank: _~Dj gallons
Subsurface
No. of
exact length width of
depth of
Drainage field
ditches ,
of each ditch t 0_ feet ditches
feet ditches inrhm
nn rem equire : linear feet
Authorized State Agent Date 07