OP RHTE# T(7 5'2✓°�NZ Harnett County Department of Public Health 24545
PERMIT # �T�l b Operation Permit
New Installation Septic TankNitrification line ❑ Repair ❑ Expansion
— PROPERTY LOCATION: Hoch tX-9
Name: (owner) H r� baa s$Sc2uC�o(LS SUBDIVISION 0N-4rw0 LOT # S
System Installer: Otgss S-,sraxr✓[a Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms `3
Type of Water Supply: ElCommunity '1KPublic ❑ Well Distance from well ao d feet
System Type: h 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.
This system has been installed in compliance with applicable North Carolina General statutes, 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.
11. 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 ❑
Alorm ❑ H2OLine ❑ PWR Line
Following are the
specifications for
the sewage disposalstem on the above captioned property.
Type of system:
❑ Conventional
Other t= 7— 1— iJvI
Septic Tank: 10 C) d gallons Pump Tank gallons
Subsurface
No. of
exact length
width of depth of
Drainage Field
ditches
_
1 of each ditch d5 feet
ditches 3 feet ditches inches
French Drain Required: Linear Net
Authorized State Agent R�L;�- Date 1�
16- 5-35`3`d4�
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