OP RHTE# 1v -s —�W668z Harnett County Department of Public Health 23353
PERMIT # � Operation Permit
2 New Installation Septic Tank 0 Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: /S�"z/ Whix ,a. zk
Name: (owner) Xad-c' C A, /44!!!, SUBDIVISION 57—W (' k_ LOT # 6
System Installer: Registration #
Basement with plumbing: el Garage ❑ ber of Bedrooms .3
Type of Water Supply: ❑ Community L'1 Public ❑ Well Distance from well feet
System Type: G fr' To a/ Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner mus cont ct Health Department 6 months prior to expirati n for permit renewal.
This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement PArmit and Construction Authorization.
PERMIT CONDITIONS:
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
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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.
2S
V. Other:
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewasposal system on the above captioned property.
Type of system: El Conventional 2 Other 5' %at?��ttt� (,na r�s {tea — - Septic Tank: I Ot�0 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 2 of each ditch 7 n feet ditches -3 feet ditches 76-210 inches
French Drain Required: Linear feet
Authorized State ARK:: �i�,,td �" — Date ��
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