OP RHTE# I�'��G� Harnett County Department of Public Health 24744
PERMIT # Operation Permit
New Installation A Septic Tank �X Nitrification Line ❑ Repair ElExpansion
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PROPERTY LO ION: TRVEtiorG 9.0
Name: (owner) 1 ih C., o ri Fiorwg s ) be_ SUBDIVISION LOT #
System Installer: C",P,,a (N c e ° � Registration #
Basement with plumbingrl!� Garage ❑ Number of Bedrooms 3
Type of Water Supply: ❑ Community !K Public ❑ Well Distance from well feet
System Type: ` ir 5 b Types V and VI Systems expire in S 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 alplicable North Carolina General Statutes, Sewage Treatment and Disposal, and all conditions of the Improvement permit and Conssmction Authonzation.
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PERMIT CONDITIONS
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ Nox
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2O1-ine ❑ PWR Line
Following are the specifications for the sewage disposal s tem on the above captioned property.
Type of system: ❑ Conventional Other ITZ F1-AJvr Septic Tank: S!j b 0 gallons Pump Tank: ACcO) gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch s 1 0 feet ditches 3 feet ditches Vq la inches
french Drain Required: Linear feet
Authorized State Agent���� !� yel\5 Date 10 S O