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OPHTE# 1 —5-2i5iq Harnett County Department of Public Health 23994 PERMIT # a`6» Operation Permit New Installation '8� Septic Tank Nitrification Line ❑ Repair ❑ Expansion PROPERTY LOCATION: Name: (owner) YcYN Q�5yzcL,G�ot4 SUBDIVISION 1LOT # System Installer: I13ocMor3et- ym9,-% Registration # Basement with plumbing: ❑ Garage Number of Bedrooms Type of Water Supply: ❑ Community E& Public ❑ Well Distance from well 100 feet System Type: .C) Types V and VI Systems expire in 5 years. (In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal. this system naz been imtalled in compliance with applicable North (arobna central Statutes. Ruhr for ltwage Treatment and Disposal, and all co'ditions of the Improvement Permit and construction Authorization 1 a ) Septic Tank: 1©6O gallons Pump Tank: gallons Subsurface No. of exact length width of depth of Drainage h D ditches _� feet Q French Drain Required: t A' �E N A T-1Dv5E E � E PERMIT CONDITIONS I. Performance: 11. 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 ❑ NX If yes, see attached sheet for additional operation cc 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 Other EZ. V)-Gw Septic Tank: 1©6O gallons Pump Tank: gallons Subsurface No. of exact length width of depth of Drainage h ditches of each ditch 345 feet ditches _� feet ditches inches French Drain Required: Linear feet Authorized State Agent Date I a \�«,.000 f � � � \. � « � � ~ \^ ®� C/� ra\ , . a. � \,� � � � ,/�. «:\\� f