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OPHTE# 137-5': �DL y Harnett County Department of Public Health 23047 PERMIT # Operation Permit New Installation :, Septic Tank X Nitrification Line ❑ Repair ❑ Expansion PROPERTY LOCATION: , � 6� � Name: (owner) w .-v,- SUBDIVISION s�zcco%d t,sc� LOT # System Installer: ti ,D Registration # Basement with plumbing: ❑ Garage X Number of Bedrooms 3 Type of Water Supply: ❑ Community '�K Public ❑ Well Distance from well feet System Type: 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. ims system has been instanea in compliance with applicable North larolina beneral Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization. rtKMII LunulnurrS: I. Performance: II. Monitoring: III. Maintenance: IV. Operation: V. Other: G1551`4 ' NNvw System shall perform in accordance with Rule .1961. As required by Rule .1961. As required by Rule .1961. Other: Subsurface system operator required? Yes ❑ No ❑ If yes, see attached sheet for additional operation conditions, maintenance and reporting. ❑ D -Box ❑ Pump ❑ Alarm ❑ H2O1-ine ❑ PWR Line Following are the specifications for the sewage disposal system on the above captio property. Type of system: ❑ Conventional Other C- i- �!�Mt3 �L ° Septic Tank: i®© �J gallons Pump Tank: gallons Subsurface No. of exact length width of depth of Drainage Field ditches - of each ditch 1 SSy feet ditches feet ditches , i inches French Drain Required: -- e 6inear fek,, Authorized State Agent `4L;"S Date � i [ >a 13 ®5 -3o` )