OP RHTE# ZQ Harnett County Department of Public Health 21 0 4 5
PERMIT # 25-7 y 9 Operation Pe it
[New Installation 5 Septic Tank ❑ Repair 2 Nitrification Line ❑ Expansion
PROPERTY LOCATION:
Name: (owner) 6,1.4 -Zg"* '4. SUBDIVISION LOT #
System Installer: -i~-ri v~_ _ Registration #
Basement with plumbing: El Garage ❑ Number of B1#ooms
Type of Water Supply: ❑ Community d Public EJ Well Distance from well 0o feet
System Type: AM ypes 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 has been installed in compliance with applicable North Carolina General Statutes Rules for Sewage Treatment and Dis al, 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.
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.
Following are the spec cations for the sewage disposal system on the above captioned property.
Type of system: Q Conventional ❑ Other
Subsurface No. of exact length
Drainage Field ditches L4 of each ditch (c6 feet
French Drain Required: linear feet
Septic Tank: /000 gallons Pump Tank: gallons
width of rt depth of
ditches 0 feet ditches l Z't inches
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Authorized State Ag.,_~/ Date
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