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OPATE0 14 �3� Harnett County D. partment of Public Health J PERMIT # a-tdt--)Ol Operation Permit New Installation 'K Septic Tank X Nitrification Line ❑ Repair ❑ Expansion PROPERTY LOCATION: Name: (owner) i� �'�.� r, \taSUBDIVISION C'') LOT # 10-� System Installer: 9og,�-7 G Registration # Basement with plumbing: ❑ Garage Number of Bedrooms T Type of Water Supply: ❑ Community 1 Public ❑ Well Distance from well i00 feet System Type:1 ?? } 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. 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 Permit and Construction Authorization 'E 4 ;, >�) p NtKMII LUNUIIIUNJ: I. Performance: System shall perform in accordance with Rule .1961. 11. Monitoring: As required by Rule .1961. III. Maintenance: As required by Rule .1961. Other: Subsurface system operator required? Yes ❑ No If yes, see attached sheet for additional operation conditions, maintenance and reporting. IV. Operation: V. Other: ❑ D -Box ❑ Pump ❑ Alarm ❑ 112O1-ine ❑ PWR Line Following are the specifications for the sewage disposal system on the above captioned pro er Type of system: El Conventional Other �vr+P7'o �� nU Septic Tank: 1000 gallons Pump Tank: NOQ 0 gallons SubsurfaceNo. of exact length width of depth of Drainage Field ditches_ of each ditch 0 G feet ditches feet ditches ���� inches French Drain Require;\ ----Linear feet Authorized State Agent NNDate f i-Lj- S--�1�715 �_