OPHTE#6-5-3f3t1 5 Harnett County Department of Public Health 24258
PERMIT # ZR543 Operation Per 't
C� New Installation Septic Tank L4' Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: /(fit 'V A6
Name: (owner) SUBDIVISION LOT #
System Installer: Registration #
Basement with plumbing: ❑ Garage Number of�Beddrr °ms
Type of Water Supply: EJ Community El Public Lel Well Distance from well / 6:D feet
System Ty AA a Types V and A Systems expire in S years.
(In accordan with Table V a) caner must contA Health Department 6 months prior to expiration for permit renewal.
This system has be installed in compliance with applicable North Carolina Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and construction Authorization.
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I. Performance: Syste shall perform in accordance with Rule .1961. y
11. Monitoring: As req ired by Rule .1961. ,s
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Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
►'fit
❑ D -Box ❑ Pump ❑ Alarm ❑ 1`12O1-ine ❑ PWR Line
Following are the specifications for the sewaa disposal system on the above captioned property.
Type of system: El Conventional LS Dther ZS—To J262)0 Lf If1. Septic Tank _I a 0 d gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch 100 feet ditches 3 feet ditches inches
French Drain Required: Linear feet
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Authorized State Date i / —
16-5-38433 (1)
16-5-38433 (2)
16-5-38433 (3)
16-5-38433 (4)
16-5-38433 (5)
16-5-38433 (6)
16-5-38433 (7)
16-5-38433 (11) 16-5-38433 (12)
16-5-38433 (8)
16-5-38433 (9)
16-5-38433 (10)