OP RHTE# I C-rf", X%0- Harnett County Department of Public Health 24282
PERMIT # e`i`���-0 Operation Permit
New Installation SeLfic Tank X Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: JEssc RD
Name: (owner) i t met --Y Qc a owla-\ SUBDIVISION _ LOT #
System Installer: F— Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms �16
Type of Water Supply: ❑ CommunityPublic ElWell Distance from well feet
System Type: w 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.
Rus system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Constru tion Authorization
YtNNII LONDHIONS:
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
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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.
❑ D -Box ❑
Following are the specifications for the
Type of system: ❑ Conventional
Subsurface
Drainage Field ditches
French Drain Require$\
Authorized State Agent "�� wy� qcw> Date
Pump ❑
Alarm ❑ 112O1-ine
❑ PWR Line
sewage disposal
o��.,Sthe above captioned property.
Other
�sYstem
G.2 't"Y..-0-%!
Septic Tank: 1 gallons
Pump Tank: gallons
exact length
width of
depth of
of each ditch 1115 feet
ditches feet
ditches )Q inches
Authorized State Agent "�� wy� qcw> Date