OP RHTE# S�` Lii,4�% I� Harnett County Department of Public Health 24884
PERMIT # `a.gSS�. Operation Permit
New Installation Septic Tank Nitrification Line F-1Repair❑ Expansion
PROPERTY LOCATION: Nv"z 0 eao Da-
Name: (owner) SUBDIVISIONNyFn;y QoNn LOT # S�j
System Installer: Registration #
Basement with plumbing: ❑ Garage �4 Number of Bedrooms L
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: Types V and VI Systems expire in S years.
(In accordance with Table V a) Owner must contact Health Departni 6 months prior to expiration for permit renewal.
I — (
This system has been installed in compliance with applicable Norah Carolina General Scatuns, Rules fox Sewage Treatment and Disposal, and all conditions of the Improvement 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.
III. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ Nox
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 sewage disposal system on the above captioned property.
Type of system:
❑ Conventional
Other - -ty Septic Tank: lia-90
gallons Pump Tank gallons
Subsurface
No. of
exact length width of
depth of
Drainage Field
ditches
of each ditch S feet ditches 3
feet ditches4� i �_ inches
French Dain eq Linear feet
Authorized State Agen``\ Sj5 Date I a T7
I 'I - 5- 51 &j
to,