OPHTE# Jr5-539 Harnett County Department of Public Health 24578
PERMIT # 2901-7 Operation Permit
New Installation Septic Tank X Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOfATION: NG'X.10
Name: (owner) GaaCro..l C* ,tn . Co . SUBDIVISION LOT # E
System Installer. G., NT oe-r Res eno c- Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms 3
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: = a 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.
[his system has been installed in compliance with applicable Nonh Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Constructions Authorization
PERMIT CONDITIONS
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
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System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ N0'A
If yes, see attached sheet for additional operation ca
maintenance and reporting.
Cl
D -Box
❑ Pump ❑ Alarm ❑
H2OLine ❑ _
Following are the specifications for
the sewage disposal system on the above captioned�roperty.
Type of system: El
Conventional
66 Other Ctati�s�'1Q�� (P'Z- Septic Tank =0 a
gallons Pump Tank
Subsurface
No.
exact length width of
depth of
Drainage Field
ditches
of each ditch % feet ditches 3
feet ditches _
French Drain Required:
inear feet
Authorized State Agent_ Date
PWR Line
gallons
K inches
ijL-s - 3q 5Q q