OPHTE# (�,-5 �b�b`I Harnett County Department of Public Health 24087
PERMIT # Operation Permit
New InstallationSeptic Tank Nitrification Line 11 Repair Expansion
PROPERTY LOCATT�� : � 9 35' boo mOWry
Name: (owner) \vASwa2 komGS INc SUBDIVISION — LOT #
System Installer: 6r, 15 c41c-ArRN�tO Registration #
Basement with plumbing: ❑ Garage XNumber of Bedrooms —3 --
Type of Water Supply: ❑ Community '�K Public ❑ Well Distance from well \0 0 feet
System Type: 7Z=. o, 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 Nord Wolks lieneral Statutes, Rules for 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.
II. Monitoring: As required by Rule .1961.
111. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No
If yes, see attached sheet for additional operation cc
IV. Operation:
V. Other:
maintenance and reporting.
❑
D -Box
❑ Pump ❑ Alarm ❑
112O1-ine ❑ PWR Line
Following are the
specifications for
the sewage disposal system on the above captioned property.
Type of system:
❑ Conventional
Other Septic Tank: 1 CC 0
gallons Pump Tank gallons
Subsurface
No. of
exact length width of
depth of
Drainage Field
ditches
3 of each ditch E._ feet ditches 3
feet ditches '2li"3C inches
French Drain Required_
Linea feet
Authorized State A¢ent Date 49
IC-- 5-31�NLi