OP RRHTE#JS''S" �"16YY2 Harnett County Department of Public Health 24511
PERMIT # Zito/S" Operation Pe mit
New installation
Septic Tank Nitrification lige. ❑ Repair ❑ Expansion
PROPERTY LOCATION:A"J
Name: (owner) ��✓vS t� 961�6� , SUBDIVISION LOT #
System Installer. Ke�� Registration #
Basement with plumbing: ❑ Garage mber of Bedrooms
Type of Water u ply: ❑ Community C3 Public ❑ Well �Distance from well feet
System Type: r�J �T 7�f /.-t¢o L% Types Y and VI Systems expire in S years.
(In accordance with Table V a) �70wner must contact Health Department 6 months prior to expiration for permit renewal.
This system has been insulted in compliance with applicable North Carolina
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I. Performance:
ll. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
I
Rules for sewage Treatment and
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and all conditions of the ImmpYement Permit and construction Authorization.
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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.
❑ D -Box ❑ Pump ❑ Alarm ❑ Ff20Lims ❑ PWR Line
Following are the specifications for the se;wa# disposal s stem on the above joptioned property.
Type of system: ❑ Conventional Other Z,. /ni�g,�j,�,,,1`r� Septic Tank: 100 d gallons Pump Tank: 60"i gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch feet ditches _ feet ditches �) inches
French Drain Required: Linear feet 9
Authorized State Agent i—..-%_�—����.<Y Date
ht e.
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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.
❑ D -Box ❑ Pump ❑ Alarm ❑ Ff20Lims ❑ PWR Line
Following are the specifications for the se;wa# disposal s stem on the above joptioned property.
Type of system: ❑ Conventional Other Z,. /ni�g,�j,�,,,1`r� Septic Tank: 100 d gallons Pump Tank: 60"i gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch feet ditches _ feet ditches �) inches
French Drain Required: Linear feet 9
Authorized State Agent i—..-%_�—����.<Y Date
15-5-37644RR (1)
15-5-37644RR (2)
15-5-37644RR (3)
15-5-37644RR (4)
15-5-37644RR (5)
15-5-37644RR (6)
15-5-37644RR (11)
15-5-37644RR (16)
15-5-37644RR (7)
15-5-37644RR (12)
15-5-37644RR (8)
15-5-37644RR (13)
15-5-37644RR (9)
15-5-37644RR (10)
15-5-37644RR (14)
15-5-37644RR (15)