OP RHTE# l6-'57DOOQ, Harnett County Department of Public Health 24080
PERMIT # ab:-)td Operation Permit
New Installation %q Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: OAS US���
Name: (owner)�o Na �Qv T / L o 2 SUBDIVISION LOT # 1
System Installer: Registration #
Basement with plumbing: ❑ Garage %K Number of Bedrooms LI
Type of Water Supply: ❑ Community )10 Public ❑ Well Distance from well feet
System Type: _ ==R 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 applicable North Carolina General Statutes, Rules for Sewage Treatment ad 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.
H. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ MCK
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
❑ D -Box Cl Pump ❑
Following are the specifications for the sewage disposal s7;, tem on the above captioned property.
Type of system: ❑ Conventional Other �w
Subsurface No. of exact length
Drainage Field i es l of each ditch 30 O feet
french Drain Required: Linear feet
Alarm ❑ H2O1-ine ❑ PWR Line
Septic Tank: LOG o gallons Pump Tank: gallons
width of depth of
ditches 3— feet ditches I inches
Authorized State Agent "'. w� Date Ccl 3 (6