OPHTE# F - s- Harnett County Department of Public Health 23792
PERMIT # Operation Permit
?"'6 3 1 (, E2 ' -New
Installation ❑Septic Tank 2Nitrification Line ❑ Repair ❑Expansion
PROPERTY LOCATION:h3 /to 3c, n J it r
Name: (owner)g&2-g SUBDIVISION LOT # E�
System Installer. Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms `i
Type of Water Supply: ❑ Community Ear Public ❑ Well Distance from well feet
System Type: , "'bic+' �u�. S..=.; 7„� ?= <>- e-Y-4� ly es 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.
G' -r: y
This system has been instilled in mmphana with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Consmuaion Authommoon.
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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 sewage disposal system on the above captioned property.
Type of system: ❑ Conventional E2' Other z T°G Septic Tank: .j 0 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch /00 feet ditches 3 feet ditches 21 inches
French Drain Required: Linear feet
Authorized State Date �/ J - /:�
15-5-35964 (1)
15-5-35964 (2)
15-5-35964 (3)
15-5-35964 (4)
15-5-35964 (5)
15-5-35964 (6)
15-5-35964 (7)
15-5-35964 (8)
15-5-35964 (9)
15-5-35964 (10)