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OP RHTE# Harnett County Department of Public Health 24285 PERMIT # a �g35 Operation Permit New Installation X Septic Tank Nitrification Line ❑ Repair ❑ Expansion PROPERTY LOCATION:Oa_o !,YZaWa,) Name: (owner) WE—AYEs1— H0mF-5 1N(•_ SUBDIVISION`Ti-lomps nk-A m LOT # System Installer:C>v;a::, 5 ras.cca Pcyp Registration # Basement with plumbing: ❑ Garage Number of Bedrooms 4 Type of Water Supply: ❑ Community Public F-1WellDistance from well MO feet System Type: b 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 mat applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization RS A4; uEcic GT raUaa>4 , 2 zr f1tsa. d t=PsS f.Jra61V; PERMIT CONDITIONS I. Performance: System shall perform in accordance with Rule .1961. 11. 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 conditions, maintenance and reporting. IV. Operation: V. Other: ❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line Following are the specifications for Type of system: ❑ Conventional the sewage dispos system on the aby�YYe captioned property. Other to ,ng,T o LZ FLp, , rr)� Septic Tank: 10©O gallons Pump Tank: Y 60y gallons Subsurface No. of exact length width of depth of Drainage Field ditches of each ditch oL40 feet ditches 3 feet ditches '30 inches French Drain Required:.._ near feet Authorized State Agent 7311;� Q_rshS Date 10141)6 I r. -s- 3g6��2