OPHTE#_ /U "~"ZSIy Harnett County Department of Public Health 21 0 5 9
PERMIT # Operation Permit
New Installation L~ Sie~ptic Tank ❑ Repair Nitrification line ❑ Exoanctnn
PROPERTY LOCATION;--:i ~
Name: (owner) o l 1 a SUBDIVISION
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System Installer: 7~ Registration # LOT #
Basement with plumbing: ❑ Garage mber of Be"ms _
Type of Water Supply: ❑ Community Public C' Well Distance from well 4 0,5> feet
System Type: ~~UF°.JhG1h ~c Types V and s ems expire in 5 years.
(In accordance with Table V a) Owner must contact Neal apartment months prior to expiration for permit renewal.
This system has been installed in compliance with
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PERMIT CONDITIONS:
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other,
North Carolina General Statutes, Ru age Treatment and
ilty
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al, n all conditions of the Improvement Permit and Construction Authorization.
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System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting
Following are the speoIcations for the sewage disposal system on the above captioned property.
Type of system: E Conventional ❑ Other
Subsurface No. of exact length
Drainage field ditches of each ditch 50 feet
French Drain Required: Linear feet
Septic Tank: / 0O gallons Pump Tank: -
width of depth of Z~
ditches 3 feet ditches
gallons
inches
Authorized State Agent Date `j 7 3 -Id
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