OPHTE# I(] `S ~3SS~o Harnett County Department of Public Health 2 0 8 5 8
PERMIT # Operation Permit
l New Installation ~n Septic Tank ❑ RepairX Nitrification Line ❑ Expansion
PROPERTY LOCATION: guF,-w.AE
Name: (owner) ~r17~cN ~Ns~ccuc-c~c~ SUBDIVISION C,N 1 Is~sES
System Installer: LOT # 4
Basement with plumbing: ❑ Garage Number of Bedrooms Registration #
Type of Water Supply: ❑ Community ~ Public ❑ Well Distance from well 100 feet
System Type: _ 'lac 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.
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PERMIT CONDITIONS:
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
IV. Operation: If yes, see attached sheet for additional operation conditions, maintenance and reporting.
V. Other.
Following are the specifications for the sewage disposal system on the above captioned pp~ropperty.
Type of system: ❑ Conventional Other C vN C'.M J~, FEZ ~`j, ,c~,e ia-
Subsurface No. of Septic Tank: 1000 gallons Pump Tank: allons
exact length width of g
Drainage Field ditches depth of
of each ditch 2 08 feet ditches 3 feet ditches a1
French Drain Required: Linear few inches
Authorized State Agent
Date