OP RHTE# n-')- S-!6 Harnett County Department of Public Health 21357
PERMIT # Operation Permit
New Installation Septic Tank ❑ RepairrX Nitrification Line ❑ Expansion
PROPERTY LOCATION: I-C-rny~L g~pc. c P-Q
Name: (owner) HOweLA- Aa,05 SUBDIVISION CoPrTC-,C-~ LOT # oL~
System Installer: Q; 1$ ST2.c c~.Pw9 Registration #
Basement with plumbing. ❑ Garage X Number of Bedrooms _ 3
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 100 feet
System Type: ~ tz 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.
ims system nas Been mstaiea in compuance wim appocaBie north tarolma beneral 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.
11. 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 disposal system on the above captioned property.
Type of system: ❑ Conventional Other G..Z'li:~ -tJ Septic Tank: Va00 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage field ditches 1 of each ditch feet ditches 3 feet ditches Ig inches
French Drain Required: _ ar~tt.
Authorized State Agent ~ -'j h~~~~~ tz ,,y6 Date _ N 3 1116
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