OPHTE# S(;o" 5'31LfK% Harnett County Department of Public Health 24602
PERMIT # a'103(o Operation Permit
New Installation �R Septic Tank )d Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: Niacc"&r, CE4'7c2ua_9.10
Name: (owner) Cuentgtt_PrAq 1NCG SUBDIVISION So—i#%,a Ki5,sw namQcrn45_LOT #
System Installer: 7Eo $a. o -o tJ Registration #
Basement with plumbing. ❑ Garage )X Number of Bedrooms 3
Type of Water Supply: ❑ Communk_)K Public ❑ Well Distance from well feet
System Type: slb Types V and YI Systems expire in 5 years.
(In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Carolina General Statute; Rules for Sewage treatment and Disposal, and all conditions of the Improvement Permit and construction Authorization
PERMIT CONDITIONS
I.
II.
III.
IV.
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Performance: System shall perform in accordance with Rule .1961.
Monitoring: As required by Rule .1961.
Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
Operation:
V. Other.
❑ D -Boz ❑
Pump ❑
Alarm ❑
H2OLine ❑ PWR Line
Following are the specifications for the
sewage disposal system on the above captioned
,properly.
Type of system: El Conventional
,$� Other 1PumQ�e C --"W G D—
311) Septic Tank: 10 0 0
gallons Pump Tanks 00 0 gallons
Subsurface No. of
exact length
width of
depth of
Drainage Field ditches
of each ditch aa5
feet ditches
feet ditchesinches
French Drain Reaukiii
Linear feet
Authorized State Agenty y\ RAMS Date
�9, L,5 -5--9I