OPHTE#
PERMIT # 2''�nS%
Harnett County Department of Public Health
Operation Permit
New Installation IR Septic Tank
PROPERTY LOCATION: J v N c
24318
Nitrification Line ❑ Repair ❑ Expansion
Name: (owner) Ce+Tr,S Y7yaaplN% SUBDIVISION TNrtN To, ,iE LOT #
System Installer: Sov.E C aPvLt4ext_ Registration #
Basement with plumbing: ❑ Garage >Z Number of Bedrooms 3
Type of Water Supply: ❑ Community -!!� Public ❑ Well Distance from well ICO feet
System Type: T Types V and VI Systems expire in 5 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 Statures, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
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PERMIT CONDITIONS
I. Performance: System shall perform in accordance with Rule .1961.
II. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ NoX
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
❑
D -Box
❑ Pump ❑
Alarm ❑ H2O1-ine
❑ PWR Line
Following are the
specifications for
the sewage disposal system onthe above capti d property.
Type of system:
El Conventional
Other Gis>\MS3FSL 'u�
Septic Tank: -11006 gallons
Pump Tank gallons
Subsurface.,No.
of
exact length
width of
depth of
Drainage field
of each ditch � feet
ditches _ feet
ditches P inches
French Drain Regrlil�Linear
feet
Authorized State Agent Date iabz)16
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