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OPHTE#M-5-a3'~21 Harnett County Department of Public Health 2 0 8 5 5 PERMIT # asps`-, Operation Permit New Installation 'K Septic Tank ❑ Repair, Nitrification Line ❑ Expansion PROPERTY LOCATION: PON©~oSA Name: (owner) rn©FrU.I ~K~ ~-loc~ lNc, SUBDIVISION C Rno Ls ~t P, SoNs LOT # 10 1 System Installer. Iss) Registration # Basement with plumbing: ❑ Garage ';W1 Number of Bedrooms Type of Water Supply: ❑ Community -X Public ❑ Well Distance from well to d feet System Type: =:5 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 Disposal, and all conditions of the Improvement Permit and Construction Authorization 7d S3,y° Zo' PU ) I 15% D 9,C-- ~ R Po~tE~t poNo~A ~~\L rcnrnt Lvnutttvnx 1. Performance: II. Monitoring: III. Maintenance: IV. Operation: V. Other. System shall perform in accordance with Rule .1961. As required by Rule .1961. As required by Rule .1961. Other. Subsurface system operator required? Yes ❑ NiX If yes, see attached sheet for additional operation conditions, maintenance and reporting Following are the specifications for the sewage disposal system on the abov captionederty. Type of system: ❑ Conventional Other C-ENP-ae-2 Septic Tank: 100Q gallons Pump Tank: gallons Subsurface No. of exact length width of depth of Drainage field ditches ` of each ditch 20o et ditches 31 French Drain Required: sa Paatrt_S feet ditches inches Authorized State Agent., Date Ilk or, q, 1 w ie,7.VN .ruar,j i~ _ 1 W4 ~ •y r:' } Mtn ~ } s a e ra 711 ~c t ►r Q s Vie. R FA y5 b a TTT f t' wtp E 4 7 ~ I ` Rs t1~ q?; e'i