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Harnett County Department of Public Health
PERMIT # a_ Operation Permit
New Installation 21603
Septic Tank Nitrification Line ❑ Repair ❑ Expansion
Name: PROPERTY LOCATION: h c I
(owner) Ha«y C1 SUBDIVISION --I
System Installer 6 0-<- C'Y-5 LOT # 3~,
Basement with plumbing. ❑ Garage ❑ Number of Bedrooms- Registration #
Type of Water Supply: ❑ Community ~ Public ❑ Well Distance from well t0 Q
System Type: ~ feet
Sy accordance with Table V a) Types V and VI Systems expire in 5 years.
(In Owner must contact Health 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 CONDfTIONS:
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 ❑ Nox
IV. Operation: If yes, see attached sheet for additional operation conditions, maintenance and reporting.
V. Other.
❑ D-Box ❑ Pump ❑
Following are the specifications for the s
di
Alarm ~~lolcFlyOline ❑ PWR Li
ewage
sposal system on the above captioned prope
Type of system: ❑ Conventional Other 11- 2-
rv
ne
rty.
Subsurface
No. of exact length
Septic Tank: Jo4G gallons Pump Tank:
gallons
Drainage field ditches 3 width of
of each ditch C 0 depth of
french Drain Required: - . feet ditches f
Linear feet
eet ditches 4,0
inches
Authorized State Ageri~
Date 2 2 V e