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OP RRHTE# la. -� -- -26YJ _ Zelz Harnett County Department of Public Health PERMIT # a b 9, 9A- Operation Permit 22940 dNew Installation 2"�Septic Tank ❑"'Nitrification Line ❑ Repair ❑ Expansion PROPERTY LOCATION: Cv P11:�rr.eJ. Name: (owner) t �)` ��. -fie r�.�� SUBDIVISION LOT # System Installer: A Registration # Basement with plumbing: ❑ Garage ❑ Number of Bedrooms 3 Type of Water Supply: ❑ Community (['Public ❑ Well Distance from well feet System Type: .g. 6 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 )tatutes, Rules Ior Sewage Ireatment and Ulsposal, and all conditions of the Improvement rermit and Construction Authorization. Cy pry rf',«- &A- 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 If yes, see attached sheet for additional operation conditions, maintenance and reporting. IV. Operation: V. Other: 1`-� —A✓ ©wed c}l� �reve ncf JIQ `V ❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line Following are the specifications for the sew3gf disposal system on the above capti ned property. Type of system: ❑ Conventional IJ✓ Other (P%" —A 40 �3 oC �`ft .1bf, Septic Tank: f (X0 gallons Pump Tank: 1000 gallons Subsurface No. of exact length width of depth of Drainage Field ditches of each ditch '30o feet ditches 3 feet ditches 16' inches French Drain Required: Liinneeaar feet l r Date l o (a®�� Authorized State Agent ��--•- /a -s = -185 37X2