OP RHTE# 1-7-5-yN 6_ Harnett County Department of Public Health 24888
PERMIT # apt ifas Operation Permit
New Installation IR Septic Tank '�k Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: W la a I—LGn.s Qn
Name: (owner) AT t-.t"'A-ta ccaasS SUBDIVISION 4Sr6C-rW R LOT # 5
System Installer: 0 Ps2.0 � k S 6P �' c— F
Y Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms
Type of Water Supply ❑ Commupj�� Public El 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 Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Carolina General Siatutes, Rules for Sewage Treatmem and Disposal, and all conditions of the Improvement Permit and Connection Authodntion.
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PERMIT CONDITIONS:
I. Performance:
II. Monitoring,
III. Maintenance:
IV. Operation:
V. Other:
System shall perform in accordance with Rule .1961
As required by Rule .1961.
As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ ROX
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional 't< Other F_Z F x c,w Septic Tank s b 00
Subsurface No. ofexact length width of
Drainage Field ditc S of each ditch feet ditches 3
French Drain Required: linear feet
Authorized State Agent 1'g;w Date
H2OLine ❑
PWR Line
gallons Pump Tank gallons
depth of
feet ditches a2Y-4' inches