OPNTE# 14 —55L4iaa Harnett County Department of Public Health 23995
PERMIT # Operation Permit
New Installation '�F< Septic Tank >( Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOLATION: Ooog Vy
Name: (owner) �'jyNN �rsgs4.t)cStoN SUBDIVISION Itwiaens (3�,acE LOT #
System Installer:IHaT7�0r-ii�5 k'1yK\5-"j C Registration #
Basement with plumbing: ❑ GarageX Number of Bedrooms L -
Type of Water Supply: ❑ Community Public ❑ Well Distance from well l00 feet
System Type: 7== n 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 on been metalled in compliance with applicable North Carolma General Statute; Rules ler Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
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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 ❑ NOX
If yes, see attached sheet for additional operation to
IV. Operation:
V. Other.
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 Z fcio u
Septic Tank: I ao O
gallons Pump Tank: gallons
Subsurface No. of
exact length
width of
depth of
Drainage -Fief ditches
3 of each ditch g 6 feet
ditches 3
feet ditches inches
French Drain Required:
Linear feet
Authorized State Agent � '-il� Date
low'.