OPHTE# 1-7-5-4111) Harnett County Department of Public Health 24887
PERMIT # a`t590 Operation Permit
New Installation �R Septic Tank" Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: 43swc5-< Ho«.G Q,%,
Name: (owner) GT 67 a16c-4 9-- I gtr s L c . SUBDIVISION M,"" F►a, LOT # 1
System Installer: Noe oe.K Registration #
Basement with plumbing: ❑ Garage 'K Number of Bedrooms H
Type of Water Supply: ❑ Community 'K Public ❑ Well Distance from well feet
System Type: 1TT 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 :prem has been installed in compliance with applicable North Carolina General Stamtes, Rules for Sewage Treatment and Disposal, and all conditions of the Impmnment Permit and Construaian Authoruation.
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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 ❑ No'15�
If yes, see attached sheet for additional operation ca
maintenance and reporting.
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❑ D -Box ❑ Pump ❑ Alarm
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional Other EZ GS-nw
Subsurface No. of exact length
Drainage Field ditches 3 of each ditch too feet
French Drain Required: Linear feet
L
H2OLine ❑
PWR Line
Septic Tank: laso gallons Pump Tank gallons
width of depth of
ditches 3 feet ditches ';L14 inches
Authorized State Agent__ _"*� �PE%-N5 Date
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