OPHTE#ireY(a-5�3}3cPO4 Harnett County Department of Public Health 24345
PERMIT # 29X•1 Z Operation Nina
New Installation 1w Septic Tank 9 Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATIOW- C /426 Cs _ i?D
Name: (owner) l,h I I>=a . } k;L I Lr SUBDIVISION LOT # 3
System Installer: c--- Registration #
Basement with plumbing: ❑ Garage Ed umber of Bedrooms .3
Type of Water Supply: ❑ Community Q" Public ❑ Well Distance from well feet
System Type: Z S%a.—. u s �—t Types V and VI Systems expire in S years.
(In accordance with Table V a) twiner must contact Health Department 6 months prior to expiration for permit reneyval.
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This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treabnam and Disposal, and all conditions of the Improvement Permit and Cnm6union Authorization.
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
Other.
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System shall perform in accordance with Asle .194Jr—� /
As required by Rule .1961.
As required by Rule .1961. Other
Subsurface system operator required? Yes EAo EY
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
❑
D -Box ❑
Pump ❑
Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
a
Type of system: ❑
Conventional f3" Other
2S6/• 'Z''��
Septic Tank:tf d gallons Pump Tank gallons
Subsurface
Drainage field
No. of
ditches
exact length
of each ditch 7 ±Sr feet
width of depth of
ditches 3 feet ditches q inches
French Drain Required:
Linear feet
Authorized State Agenf C %�(A.��L•fs�'� �f" Date /— 3v -/7
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1
16-5-38409 (1) 9 16-5-38409 (2) 16-5-38409 (3) 16-5-38409 (4) 16-5-38409 (5)
16-5-38409 (6) 16-5-38409 (7) 16-5-38409 (8) 16-5-38409 (9) 16-5-38409 (10)
16-5-38409 (11) 16-5-38409 (12) 16-5-38409 (13) 16-5-38409 (14) 16-5-38409 (15)
16-5-38409 (16) 16-5-38409 (17) 16-5-38409 (18) 16-5-38409 (19) 16-5-38409 (20)