OP RRNTE# I` - s- 3/z/Z Harnett County Department of Public Health 23594
PERMIT # Z 2334-.27 Operation Per It
EI/New Installation 5 Septic TankNitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:&�IS3Z /Z&
Name: (owner) —n SUBDIVISION LOT # _I
System Installer: G/.r,, - 66 '> Registration #
Basement with plumbing: ❑ Garage /Number of Bedrooms �
Type of Water Supply: El Community Q1 Public ❑ Well Distance from well feet
System Type:% d UZ �Z,d�� �.. �d � i t�,.M, irtr G,9 -7.t. es V and VI Systems expire in 5 years.
(In accordance with Table V a) I. Owner must contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in
Carolina General Statutes, Rules for
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10
Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
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PERMIT CONDITIONS:
I. Performance: System shall perform in accordance with Rule .1961. ()t)
II. 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 ❑
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional ❑ Other
Subsurface No. of exact length _®
Drainage Field ditches 2 of each ditch % feet
Alarm ❑
1-12O1-ine ❑
PWR Line
Septic Tank:Z� () Q gallons Pump Tank: gallons
width of depth of
ditches 3 feet ditches Z inches
French Drain Required: Linear feet
Authorized State A nt Date -5-
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14-5-34917RR (1) 14-5-34917RR (2) 14-5-34917RR (3) 14-5-34917RR (4) 14-5-34917RR (5)
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14-5-34917RR (6) 14-5-34917RR (7) 14-5-34917RR (8) 14-5-34917RR (9) 14-5-34917RR (10)