OPHTE# I4-534�M Harnett County Department of Public Health
*►03 24111
PERMIT # a
Operation Permit
New Installation 'ISt Septic Tank �X Nitrification Line ❑ Repair ❑ Expansion
\, PROPERTY LOCATION: I s 4 %'fill, Vp
Name: (owner) �+GE ride SUBDIVISIONMae �6Sot AC 'L LOT # 93
System Installer: F-zc^E 6CL Registration #
Basement with plumbing: ❑ Garage '5( Number of Bedrooms H
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 100 feet
System Type: 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.
nas peen installed in compliance wish applicable North Carolina General Statutes, Nines for Sewage Treatment and Disposal an
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I. Performance:
II. Monitoring.
III. Maintenance:
IV. Operation:
V. Other.
uiuse:
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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
yes, see attached sheet for additional operation conditions, maintenance and reporting
❑ D -Box ❑ Pump ❑ Alarm ❑
conditions of the Improvement Permit and Constmajon
H2OLine ❑
PWR Line
Following are the specifications for the sewage disposa(Q
rl sys�tem on the above captioned,property.
Type of system:
El X Other Cti an >�' Septic Tank: sOOO gallons Pump Tank:gallons
Subsurface ht
exact length width of depth of
Drainage Field ditches of each ditch QDO feet ditches 50`3 feet ditches QQ ---<D inches
French Drain Required: Lugar feet
Authorized State Agent faro Date