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OP RNTE# 17-5 Harnett County Department of Public Health 24706 PERMIT # 7 cl 0cl'3 Operation Perm* New Installation ErSeptic Tank ET Nitrification Line ❑ Repair ❑ Expansion PROPERTY LOCATION: 33/ Ave p, A Av (etiti, k ea, sn nl�� Name: (owner) w o n n C r .cEs e L T SUBDIVISION A-sr�) 0,,,d LOT # System Installer: Registration # Basement with plumbing. ❑ Garage & Number of Bedrooms Type of Water Supply: ❑ Community +.Yrblu—❑ Well Distance from well feet System Type: ";'u [ [v n 6 . Types V and VI Systems expire in S years. (In accordance with Table V a) Owner mu contact Health Department 6 months prior to expiration for permit renewal. msunea in mmpante cam applicable aorto Lamlma beneral Statutes, Rules for Sewaee Treatment and Disooul. and 43ti 5;=� Performance: System shall perform in accordance with Rule .1961 Monitoring As required by Rule .1961. Maintenance: As required by Rule .1961. Other. Subsurface system operator required? Yes ❑ No Eg-� If yes, see attached sheet for additional operation conditions, maintenance and reporting. IV. Operation: V. Other. of the Improvement Permit and Construction T6 25�,� tiEUv GTao .�! ❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine a 'CV Following are the specifications for I — Type of system: ❑ Conventional flYiher�Z . z i Septic Tank: / a150 gallons Pump Tank: gallons Subsurface No. of exact length width of depth of Drainage Field ditches 5 of each ditch 6,O feet I ,S I �1 la1 LTII I4+� CJI 1 I Pry.a Pc.� 1 Pay. -I ---II 43ti 5;=� Performance: System shall perform in accordance with Rule .1961 Monitoring As required by Rule .1961. Maintenance: As required by Rule .1961. Other. Subsurface system operator required? Yes ❑ No Eg-� If yes, see attached sheet for additional operation conditions, maintenance and reporting. IV. Operation: V. Other. of the Improvement Permit and Construction T6 25�,� tiEUv GTao .�! ❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line Following are the specifications for the sewage disposal system on the above captioned property. Type of system: ❑ Conventional flYiher�Z . z i Septic Tank: / a150 gallons Pump Tank: gallons Subsurface No. of exact length width of depth of Drainage Field ditches 5 of each ditch 6,O feet ditches �_ feet -�� ditches inches French Drain Required: Linear feet Authorized State Agent Date /<.) /ice/�©e"{— in" 9t A.