OP RHTE#0c1-5-235 13~. Harnett County Department of Public Health 21 3 6 9
PERMIT # Operation Permit
l New Installation 'K Septic Tank ❑ Repair Nitrification Line ❑ Expansion
PROPERTY LOCATION: ►-P,~t~SEri
Name: (owner) ST E..P)A E-- SO ~v~to ~s 1 ti SUBDIVISION \j W" U-[ LOT # 3~
System Installer: XC)C_0 c_'4 Registration #
Basement with plumbing: ❑ Garage ,?T, Number of Bedrooms tf.__--
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 100 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.
11115 spcem nos peen mstanea in
with applicable North larohna General Statutes, Rules for Sewage Treatment and
and all conditions of the
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PERMIT rn kinITIAMC.
Permit and Construction Authorization.
1. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
CC'
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ No
If yes, see attached sheet for additional operation conditions, maintenance and reporting
Following are the specifications for the ewage disposal system on the above captioned property.
Type of system: El Conventional Other CZ F pow Septic Tank: 4ao d gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch b feet ditches 3 feet ditches inches
French Drain Required: `-,Unear4tet
Authorized State Agent ~a ~ ~ i s Date 41 'S I I6
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