OPHTE # 1 E; Harnett County Department of Public Health 23562
PERMIT # Operation Permit
New Installation >5, Septic Tank Nitrification line 11 Repair 1:1 Expansion
PROPERTY LOCATION: � C rrKtA
Name: (owner) ia—c-A �N C0— SUBDIVISION LOT #
System Installer: )- a-\ c.f..to t Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms 13
Type of Water Supply: ❑ Communi �j Public El Well Distance from well 100 feet
System Type: ,�� Types V and VI Systems expire in 5 years.
(In accordance with Table V a) 11 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.
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rEnrin WNUMVira:
I. Performance: System shall perform in accordance with Rule .1961.
II. Monitoring: As required by Rule .1961.
111. 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 ❑ 1-12O1-ine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional Other 2- 'fix ''r Septic Tank: 1000 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches LA of each ditch r- 0 feet ditches j feet ditches -6X— inches
French Drain Required: Linear feet
Authorized State Agent ` - 9, i Date
1�-�-3s'31�