OP RHTE#>a-s a3�2 Harnett County Department of Public Health 23727
PERMIT # :;L`1 M, Operation Permit
New Installation '�R Septic Tank Tank 'XNitrification line ❑ Repair ❑ Expansion
PROPERTY LOCATION: W IQr—
Name: (owner) SPy �
raomc� SUBDIVISION 1C ENIPN �Pc:r�S LOT # L
System Installer. N o+n-O aN Registration #
Basement with plumbing. ❑ Garage Number of Bedrooms�1— _ +
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 100 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.
inis SyStem has been installed in mmpliana with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions ul the Improvement Permit and Construmon Authorization.
Sc
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310
11
ID VS E
SaaEQNNQD Ott
PERMIT CONDITIONS
I. Performance: System shall perform in accordance with Rule .1961.
11. 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 ❑
H2OLine ElPWR Line
Following are the
specifications for
the sewage disposal system on the above captioned property.
Type of system:
❑ Conventional
�$ Other Puc+Q�o >y2F on Septic Tank 10
gallons Pump Tank: 1000 gallons
Subsurface
No. of
exact length width of
depth of
Drainage Field
ditches
I of each ditch feet ditches 3
feet ditches 1$'34 inches
trench Uraln Required: Linear feet
Authorized State Agent Date —i I 1�--