OP RHTE# -I Harnett County Department of Public Health 24858
PERMIT # 2ti23�;' Operation Permit_
13`—New Installation Z'Septic Tank mon Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: 4+` Ate, V>1-. �ti t,h�ik. " srt ewt ,sS
Name: (owner) Warm C- A&6 g t on 21via SUBDIVISION A„c0 GL, --'LOT # SS
System Installer: Registration #
Basement with plumbing: ❑ Garage umber of—Bedrooms; 3
Type of Water Supply: ❑ Community 9--Fu�bric ❑ Well Distance from well feet
System Type: Types V and VI Systems expire in S years.
(In accordance with Table V a) wner must contact Health Department 6 months prior to expiration for permit renewal.
Ims 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 Constm<tion Authorization
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PERMIT CONDITIONS
I. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No Kr
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 seewwage�osal system on the above ca tinned property.
Type of system: ❑ Conventional L3' (Other Septic Tank: gallons Pump Tank gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 3 of each ditch E56 feet ditches -3 feet ditches '8 inches
French Drain Required: Linear feet
Authorized State Agent Date la I la aot�