OPHTE# /a-r -AbYf® Harnett County Department of PubliC health
PERMIT # 02 b a 3 Operation Permit 22186
d New Installation C' Septic Tank ET-Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: W p
Name: (owner) f -L r „'4. r, 6_ SUBDIVISION �we2�.�c� +ed LOT #
System Installer: A-4 h �v o o z4,, Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms 13
Type of Water Supply: ❑ Community Z' 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.
I> ,71.1 1. UCCA w5wieu in compuance wim 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:
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 ❑ No Efr
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the seewwaKddisposal s tem on the above captioned ro erty.
Type of system: ❑ Conventional Lam' Other iv �1� vc `% �a��e, Septic Tank: gallons Pump Tank: /600 gallons
Subsurface No. of exact length width of depth of
Drainage Field _ _es i of each ditch oZ 0 feet ditches 3 feet ditches / 6 — Z- G inches
French Drain Required: t "`— _L�iitear feet
Authorized State Agent ° _ _ \� \ \`�.�� 5 Date