OPNTE# ~ U Harnett County Department of Public Health 2 0 8 5 2
PERMIT # Operation Permit
C~6ew Installation FL-Septic Tank ❑ Repair ifr Nitrification Line ❑ Expansion
PROPERTY LOCATION:
-ade~~s~ ~d.
Name: (owner) 1-3,A4 Pta~e~ SUBDIVISION C QL~a LOT # g~
System Installer. Ted Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms
Type of Water Supply: ❑ Community 'Public ❑ Well Distance from well feet
System Type: i~. C Types V and VI Systems expire in S 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 Sew a Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
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PERMIT 1`001TIM
L Performance: System shall perform in accordance with Rule .1961.
If. 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 seewwa;r disposal system on the above ptioned property.
Type of system: ❑ Conventional L~J Other (y v t, C k q 1, 1--, 4~ Septic Tank: l gallons Pump sank: gallons
Subsurface No. of f exact length width of depth of
Drainage field ditches / of each ditch o2 a feet ditches -3 feet ditches inches
French Drain Required: Linear feet
Authorized State Age~((,--~, "0!~j~ Date A/ 51l q 0 f
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