OPATE# I L4-5-_tA'�� Harnett County Department of Public Health -1
2353 i.
PERMIT # Operation Permit
New Installation %K� Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: :�Sv eao 4LlN
Name: (owner) �5 46Qi1-1DING'�"C- SUBDIVISION `T, sGc—", o1 "S"G LOT # 1�
System Installer: Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well LbQ) feet
System Type: L1 n, 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.
tnis system nas ween mstaueo in compuance witn appucaoie norm carouna t,eneras xatutes, naves Tor sewage treatment ana uisposai, ana an conanions oT the Improvement Permit ana lanstructlon AUtnorization.
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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.
V. Other:
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑
Following are the specifications for the sewage disposal system on the abo�e,,„c�aptioKd property.
Type of system: ❑ Conventional Other � `� 2 l�,t J Septic Tank: ktC)U gallons Pump Tank:
Subsurface No. of exact length width of depth of
Drainage Field ditches )i of each ditch ZZ60 feet ditches feet ditches _
French Drain Required: 'near feet
Authorized State AgentDate
PWR Line
gallons
\'�F inches