OP RHTE# I-7"S-t-10'�'Q Harnett County Department of Public Health 24746
PERMIT # aca1 133 Operation Permit
New -installation 'K Septic TankX Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: I!QvQbexui
Name: (owner) \ACt-'s.co SUBDIVISION LOT # Gcl
System Installer. T e)oo. sv Registration #
Basement with plumbing: ❑ GarageX Number of Bedrooms 3
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well feet
System Type: _ l 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 spam na been installed in mmphana with applicable Norah Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Con inn ion Authorization.
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1. Performance: System shall perform in accordance with Rule .1961.
ll. Monitoring: As required by Rule .1961.
111. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ 110_81�
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other. D "'.- I ass P�cle;o Tay P. ulc.oC-cl
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned1nroperty.
Type of system: ElConventional Other C.1'Ae+36rL u% Septic Tank s ne 0 gallons Pump Tank gallons
Subsurface _ No. of exact length width of depth of
Drainage Field _ditche of each ditch 3 Oy feet ditches 3 feet ditches 14 inches
French Drain Reauired: feet
Authorized State Agent Qc�y\S Date I