OPHTE# +6-5-31 6-S-) Harnett County Department of Public Health 24525
PERMIT # 016).6 Operation Permit
New Installation Set Tank Nitrification Line Repair 11Expansion
\ PROPERTY LOCATION:2 Sc.0youN sa
Name: (owner) Gat—j eoi saJ ,C'ct lGS SUBDIVISION LOT# ST
System Installer: Coo, E Gal NCSz Registration #
Basement with plumbing: ❑ GarageX Number of Bedrooms 3
Type of Water Supply: ❑ Community >q Public ❑ Well Distance from well feet
System Type: 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 Statutes, Rules for Sewage Treabnem 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.
ll. 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 ElAlarm ElH2OLine ❑ PWR Line
Following are the specifications for the sewage disposals stem on the abovQw�P,bone;,1,,groperty.
Type of system: ❑ Conventional Other �a^c�0F1L, �s✓y'/ Septic Tank: 1<500 gallons Pump Tank gallons
Subsurface of exact length width of depth of
Drainage Field ditches of each ditch feet ditches 3 feet ditches I inches
French Drain Required; aea
Authorized State Agent Date