OPHTE# (1-s _" Harnett County Department of Public Health 24695
PERMIT # 2.9 3G b Operation Permi
1>1 Aew Installation ['Septic Tank EJ -Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: 33o Ave L, Pnnd Or. iCh l l ate eo. . 5:1 ly;t�
Name: (owner) �Xc,/�.,
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System Installer. r I Registration #
Basement with plumbing: El Garage Number of Bedrooms 3
Type of Water Supply: ❑ Communityublic ❑ Well Distance from well feet
System Type: ZS %u /t A_Ne k' > !42" � 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 applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Constzmioa Authorization
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PERMIT CONDITIONS
I. Performance: System shall perforin 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 ❑ No
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewageiposal system on the above captioned�roPerty.
Type of system: ❑ Conventional LYOther �� r4c . Septic Tank 13,50 gallons Pump Tank gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch LCYJ feet ditches feet ditches _ _ inches
French Drain Required: Linear feet
Authorized State Agent-E%/r��=���$S Date t"If
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