OP RHTE# 07 -s- 119 Harnett County Department of Public Health 20021
PERMIT # Qperation Permit
2 New Installation 1Z Septic Tank ❑ Repair 2 Nitrification Line ❑ Expansion
PROPERTY LOCATION:,L~,,
Name: (owner) SUBDIVISION :22~L LOT # 39
System Installer: Registration #
Basement with plumbing: ❑ Garage umber of Bedrooms
Type of Water Supply: ❑ Community Q Public ❑ Well Distance from well feet
System Type: - 7 c1Z d zr 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
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Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
North (aralina General Statutes, Rules for
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PERMIT CONDITIONS:
1. 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 ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
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Following are the specifications for the sewa disposal system on the above captioned property.
Type of system: ❑ Conventional Other Zs% f C ~Q ~&A Septic Tank:
Subsurface No, of /000 gallons Pump Tank: gallons
exact length width of depth of
Drainage Field ditches t of each ditch 916 feet ditches -J feet ditches
ITT--- inches
French Drain Required: Linear feet
Authorized State Agent-iyr /V
Date J, f tf -(J