OP RHTE# 1%-'5.9 LSnorL Harnett County Department of Public Health 24738
PERMIT # .211JIG`15 Operation Permit
New Installation 'R SepticTankX Nitrification Line F-1Repair El Expansion
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PROPERTY LOCATION: Wsa.a_ Loco.-, Qv
Name: (owner) -N L9%-11 le— Cv v,`Z" . 1 N SUBDIVISION S W San Ntyls , LOT # 30,_
System Installer. "od:A1 -9 � ` c. Registration #
Basement with plumbing: ❑ GarageX Number of Bedrooms
Type of Water Supply: ❑ Commuum Public El Well Distance from well feet
System Type: � 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.
This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of she Improvement Pemdt and fonshuction Authonaauon.
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PERMIT CONDITIONS:
I. Performance:
System shall perform in accordance with Rule .1961.
Il. Monitoring:
As required by Rule .1961.
III. 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.
IV. Operation:
V. Other.
❑
D -Box ❑ Pump ❑
Alarm ❑ K2OLine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional Other EZ FS-oW
Subsurface No. of exact length
Drainage Field ditches 1 of each ditch -"'40 feet
French Drain Rauiired: ��Llnear feet
Septic Tank 1000 gallons Pump Tank gallons
width of depth of
ditches ,3 feet ditches G0 inches
Authorized State Agent �� ����� 5 Date