OP RHTE# ~371 Z Harnett County Department of Public Health
PERMIT #FS'~ Operation Permit 21 5 3 4
Z "'New Installation 2 "'Septic Tank Nitrification Line El Repair El Expansion
PROPERTY LOCATION: ti, red.
Name: (owner) CQ/ `{LCn SUBDIVISION LOT # ;L
System Installer: Registration #
Basement with plumbing. ❑ Garage Number of Bedrooms 3
Type of Water Supply: ❑ Community Pl" Public ❑ Well Distance from well feet
System Type: Types V and VI Systems expire in S years.
(In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
imm >ptem nay oeen mscaneo in compuance wim
nortn tarouna beneral statutes, Rules for kwage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
7
9
.0
1 LIII Wilul I M13.
1. Performance: System shall perform in accordance with Rule .1961.
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 ❑ Alarm ❑ H20Line ❑ PWR Line
Following are the specifications for the sewadisposal system on the above captioned property.
Type of system: ❑ Conventional I!1 Other &Z rXo,.2 Septic Tank: gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 3 of each ditch feet ditches feet ditches inches
French Drain Required: Linear feet
Authorized State AgenLZ-Z~,~~ ° Date ~ ~as`~~
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