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OPHTE# 10-5`149x\`7 Harnett County Department of Public Health PERMIT Operation Permit New Installation tR~ Septic Tank X Nitrification Line ❑ Repair ❑ Expansion PROPERTY LOCATION: Ge E t~,~~cs Qci Name: (owner) `Spt,o3,j C~\tc , SUBDIVISION CN2.- e~P+ SG~5oN5 LOT # System Installer: Registration # Basement with plumbing: ❑ Garage Number of Bedrooms 4 Type of Water Supply: ❑ Community Public ❑ Well Distance from well t 0 0 feet System Type: BSc Types V and VI Systems expire in 5 years. (In accordance with Table V a) J 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 t© d g a r- P w fl rev` QL vG rtmI LvNumum: 1. Performance: System shall perform in accordance with Rule .1961. II. Monitoring: As required by Rule .1961. III. Maintenance: As required by Rule .1961. Other: Subsurface system operator required? Yes ❑ NOA If yes, see attached sheet for additional operation conditions, maintenance and reporting. IV. Operation: V. Other: ❑ D-Box ❑ Pump ❑ Alarm ❑ H20Line ❑ PWR Line Following are the specifications for the sewage disposal system on ther ~above captioneproperty. Type of system: El Conventional Other CrAAm9.£r2- wt U\ c.Y-4 h Septic Tank: 100c~ gallons Pump Tank: gallons Subsurface No. of exact length width of depth of Drainage Field ditches of each ditch I S 0 feet ditches 3 feet ditches A4-' 4 inches French Drain Reauired: _ ear t Authorized State Arent " ~ " X &W5 Date 1 a~a3~la 11 11 ^ ~Z-yFy7