OPNTE# r4-a ® 3zs2s° Harnett County Department of Public Health 23326
PERMIT # 2 �� z3 Operation Permit
121 New Installation C�KSeptic Tank 2 Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: S3 S 44�
Name: (owner) �°�,��ac.� SUBDIVISION LOT #
System Installer: lf"cs-4— !!�fk Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms 3
Type of Water Supply: ❑ Community 2' Public ❑ Well Distance from well feet
System Type: 6% 5 G' BZ Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must cant .t falth Department 6 months p "or to expiration for permit renewal.
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This system has been installed in compliance with applicable No th Carolina General Statutes, Rules for Sewage Treat nt and Disposal, and all conditions )I the Improvement Permit and Construction Authorization.
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PERMIT CONDITIONS:
I. Performance:
11. Monitoring:
ill. Maintenance:
IV. Operation:
V. Other:
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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 sewa p disposal system on the above captioned property.
Type of system: ❑ Conventional Z Other W16 UOU ttcn.- Siclit. -- Septic Tank: 1060 gallons Pump Tank: gallons
Subsurface No. of exact length I width of depth of
Drainage Field ditches 4 of each ditch 60 feet ditches 3 feet ditches inches
French Drain Required: Linear feet
Authorized State Age � Date G Z-`, ° 0
14 -5- 32825(2) 14 -5 -32825 (3) 14 -5 -32825 (4) 14 -5 -32825 (5) 14 -5- 32825(6)
14 -5- 32825(7) 14 -5 -32825 (8) 14 -5 -32825 (1)