OPH T E # 96� 6 Harnett County Department of Public Health 23516
PERMIT # Z S®785 —/ Operation Permit
L1 New Installation Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:
Name: (owner) SUBDIVISION LOT # _L
System Installer: C t} Registration #
Basement with plumbing: ❑ Garage Goumber of Bedrooms y
Type of Water Supply: ❑ Community Y Public ❑ Well Distance from well feet
System Type: Z'SV6KRtq,� S,_-, 4*.- -74-, C'_h _ Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner AVOMacYHealth 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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PERMIT CONDITIONS:
I. Performance:
II. 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 ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sa disposal system on the above captioned property.
Type of system: ElConvenewational Other Septic Tank: 10 0 d gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch t n" feet ditches feet ditches z`i > / inches
French Drain Reauired: Linear feet
Authorized State Aie�fl��s �—� ( /`// Date Date 3 -3I" s
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