OPHTE# ( J—��13�'� Harnett County Department of Public Health 24880
PERMIT # ah�'✓�) Operation Permit
�l New Installation iS( Septic Tank �K Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: Nv^m',cysu L -G sor
Name: (owner) Cel -1-7) O N CIO N soc ,Co , SUBDIVISION LOT # 9
System Installer: Q.op�o SEv c.c_ Registration #
Basement with plumbing: ❑ Garage '15� Number of Bedrooms
Type of Water Supply: ❑ Community K Public ❑ Well Distance from well feet
System Type: i`Sij 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.
[his system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Impmeement Permit and Construction Authorization.
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PERMIT CONDITIONS
I. Performance: System shall perform in accordance with Rule .1961.
11. 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 ❑ H2O1-ine ❑ PWR Line
Following are the
specifications for the dispos�,Sl
system on the above captioned property.
Type of system:
+s�e,w{age
❑ Conventional �L Other `V
Mgr N d Ly 1-*�/
Septic Tank: ►OOG gallons Pump Tank 1000 gallons
Subsurface
No. ofexact
length
width of depth of
Drainage Field
ditches 3
of each ditch 5 D feet
ditches 3 feet ditches I !g inches
French Drain Required: !'`, Linear feet
Authorized State Agent Date l al Z1 W)
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