OPHTE# Al - -nko&
PERMIT # 2606
Name: (owner) re-4-0-0-
System Installer: 1 ~ L
Basement with plumbing: ❑ Garage
Type of Water Su ply: ❑ Community
System Type: i
(In accordance with Table V a)
Harnett County Department of Public Health
,-Operation Permit 21 7 0 9
LJ New Installation Q Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: ~y ,4°
SUBDIVISION 0 /-7"3el-~s LOT #
Registration #
Number of Bedrooms --D
Public ❑ Well Distance from well feet
Types V and VI Systems expire in 5 years.
wner must contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with
1,3 -7
North larohna jeneral Hatutes, Rules tar )ewage Treatment and uisposai, and all conpmons of me improvement rermTc ana s.onstrucnon eumonzadon.
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1.6
PERMIT CONDITIONS:
1. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
V. Other:
❑ D-Box ❑ Pump ❑ Alarm ❑ H20Line ❑ PWR Line
following are the specifications for the sew (disposal system on the above captioned property
. c,
Type of system: El Conventional Other fa Ob r2 T i~t Zt,' ' Septic Tank: X11 00 gallons Pump Tank: O C> gallons
Subsurface No. of exact length f j3 width of depth of
Drainage Field ditches 3 of each ditch ~ feet ditches ~ feet ditches g:9 inches
French Drain Required: Linear feet
Authorized State Agent ~ Date c