OPHTE# I — 5r"C69S Harnett County Department of Public Health 24532
PERMIT# �clti5C Operation Permit
New Installation V Septic Tank '�W Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: Nv ; Ga mss
Name: (owner) Ev cttf--'7 E (�056'i SUBDIVISION E-62,Ei) G I—t_T- LOT #
System Installer: 0-rtis 5s 2,cwp o Registration #
Basement with plumbing. ❑ Garage ❑ Number of Bedrooms 3
Type of Water Supply: ❑ Community '( Public ❑ Well Distance from well feet
System Type: m 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 (arms General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Combustion 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 ❑ No
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
❑
D -Boz ❑
Pump ❑ Alarm ❑
112OLine ❑ PWR Line
Following are the
specifications for the sewage disposal system on the above captioned property.
Type of system:
❑ Conventional Other
EZ, 11zw Septic Tank: 10 0 0
gallons Pump Tank: gallons
Subsurface
No. of
exact length width of
depth of
Drainage Field
dude
of each ditch a� feet ditches 3
feet ditches inches
French Drain Required:
Authorized State hent Date