OPHTE# l G —S- 9%v ZS Harnett County Department of Public Health 24132
PERMIT # Z907-6 Operation Permi �
New Installation eptic Tank [(t "Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: Sr,�jo'cr n 1�.
Name: (owner) (� n l}o SUBDIVISION PYca uk an p ,T ✓,�cm LOT # �
System Installer: - ;P, C�< ��nvc Registration #
Basement with plumbing: ❑ Garage 9umber of Bedrooms
Type of Water Supply: ❑ Community lvr'Public ❑ Well Distance from well feet
System Type:°i 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.
(his sysim has been installed in compliance with applicable North Carolina General stawtes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Cunmttion Authorization.
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PERMIT CONDITIONS
I. Performance:
11. Monitoring:
Ill. Maintenance:
IV. Operation:
V. Other.
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sews disposal stem on the above captioned property.
Type of system: El Conventional E7 Other UK ti¢ 'tom 64
Gy1(udiVYC Septic Tank /(X0 gallons Pump Tank 4 ', Y> gallons
Subsurface \No. of exact length S7 a10�s width of depth of
Drainage Fieldd�°�— of each ditch t�(' feet ditches .3 feet ditches lR"Z4 inches
French Drain RequIredt mar feet
Authorized State hent —N�
Date