OP RHTE# 1Z- -:E- - ZSy4S /z Harnett County Department of Public Health 23344
PERMIT # ��G a - Operation Per It
[2 New Installation Septic Tank 2 Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: T-r-- ��rL-2-4 -' 2�
Name: (owner) 1ZA' c 4 ?M11-
SUBDIVISION LOT #
System Installer: �V!L� S% cc-r— Registration #
Basement with plumbing: ❑ Garage ��umber of Bedrooms feet
Type of Water Supply: E:1 Community fJ Public El Well Distance from well
System Type: % 1 `-� rL Types V and VI Systems expire in 5 years.
y yP Owner must ontact Health Department 6 months prior to expiration for permit renewal.
(In accordance with Table V a) -
This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all con i i f-ef�lmprovement Permit and Construction Authorization.
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PERMIT CONDITIONS:
1. Performance: System shall perform in accordance with Rule .1961. vyr 6
11. Monitoring: As required by Rule .1961. 1A, VS
III. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes El No El i T.— fl.�
If yes, see attached sheet for additional operation condi 'ons, aintenance and reporting.
IV. Operation:
V. Other:
F-1 D -Box El Pump F-1 Alarm ❑ 1-12O1.ine 11 PWR Line
Following are the specifications for the sewage disposal system on the above captioned property. Septic Tank: IG�oO gallons Pump Tank: gallons
Type of system: ❑ Conventional 13'r Other � '— /c P ---- depth of
Subsurface No. of 3 exact length t width of P
Drainage Field ditches
of each ditch � feet ditches - feet ditches /� inches
French Drain Required: Linear feet
Authorized State
Date �_ f
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