OPHTE# 15' 5-36` 13 Harnett County Department of Public Health 23977
PERMIT # �SU�I Operation Permit
New lnstallatiori�X Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: Sp2')N G 5&oweD , 0 a
Name: (owner) Co mg tg u-I�wo Iw is, SUBDIVISION LOT # 56
System Installer: `: "r,l Registration #
Basement with plumbing: ❑ GarageX Number of Bedrooms
Type of Water Supply: ❑ CommunityPublic ❑ Well Distance from well SO C) 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.
This system has been installed in compliance with appliable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
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I. Performance: System shall perform in accordance with Rule .1961.
If. 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 C
Following are the specifications for the
Type of system: 1:1Conventional
Subsurface No
Drainage Field ditches
French Drain Recfuirelr Q
Pump ❑ Alarm 11
H2OLine ❑
PWR Line
sewage disposal system on the abovecaptioned erty.
CcraP62 Z
Other "4a-7 Septic Tank: gallons Pump Tank: gallons
exact length width of depth of
of each ditch ILL0 leer ditches 3 feet ditches �Zt°''20 inches
Authorized State Agent G—W, Date
8