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OPHTE #, t14 — 5'— 3g59!9' Harnett County Department of Public Health 23358 PERMIT # 7-904yy ,Operation Per it ©'' Neww'lnstallation �' Septic Tank Nitrification Line ❑ Repair ❑ Expansion PROPERTY LOCATION: / 7 Name: (owner) SUBDIVISION (, e,(- < C °� LOT # IT System Installer: JD H-fO Registration # Basement with plumbing: ❑ Garage ❑ Number of Bed ms =t— Type of Water Supply: ❑ Community El Public L!f Well Distance from well 100 ` feet System Type: ?S� /�s t2Et>t1 C�F7,6�.) u�z �' eg �" ypes 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. PERMIT CONDITIONS: I. Performance: 11. 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 ❑ If yes, see attached sheet for additional operation conditions, maintenance and reporting. ❑ D -Box ❑ Pump ❑ Following are the specifications for the sewage isposal system on the above captioned property. Type of system: ❑ Conventional Other Subsurface No. of exact length Drainage Field ditches of each ditch feet French Drain Required: Linear feet Alarm ❑ H2O1-ine ❑ Septic Tank: 10 a 0 gallons Pump Tan width of depth of ditches feet ditches _ PWR Line Tank Authorized State Atr x�� _ 92nni— Date 2 gallons Z ) 116 inches