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OPHTE# 1��3��b� Harnett County Department of Public Health 24289 PERMIT # Operation Permit New Installation "E� Septic Tank �< Nitrification Line ❑ Repair ❑ Expansior PROPERTY LOCATION: L%MUEL IilLacZ- Qn Name: (owner) G%oco 9-Z%N Asow `Ati SUBDIVISION LOT # 4 System Installer. E OONE Cse.L Registration # Basement with plumbing: ❑ Garage Number of Bedrooms L+ Type of Water Supply: ❑ Community Public ❑ Well Distance from well Sbq feet System Type: A 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 with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization d,7 E � D i 4 J PERMIT CONDITIONS I. Performance: System shall perform in accordance with Rule .1961. 11. 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. ❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line Following are the specifications for the sewage disposal system on the abov wptil property. Type of system: ❑ Conventional A Other C� ACnBF:2©�' Septic Tank t t00 gallons Pump Tank gallons Subsurface No. of exact length width of depth of Drainage field s 1 of each ditch aZ 0O feet ditches 3 feet ditches a.� inches French Drain Required '*4iaear feet Authorized State Agent \'X 5 Date t0(17(11 ►C-5=3,G7Gz