OP RRNTE# 16-5--513161,t Harnett County Department of Public Health 24775
PERMIT #2—fl 79 /Operation P mit j
0 New Installation Septic Tank E✓ Nitrification Line ❑ Repair ❑ Expansion
x PROPERTY LOCATION- SS
Name: (owner) d Q 2AkX.5 SUBDIVISION / LOT # lv
System Installer: TC/n1;diG .a -s Registration #
Basement with plumbing: ❑ Garage Number of 11040114
Type of Water Sao ❑ Commlinity ElPublic M Well Distance from well 1W feet
System Type: t..:00 r/z 1�0� S e y es V and VI Systems expire in S years.
(In accordance Ith TabletY a) Owner must coFlAlth Department 6 months prior to expiration for permit renewal.
This 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 Construction Authorisation.
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PERMIT CONDITIONS
Performance: System shall perform in accordance with Rule .1961
Monitoring: As required by Rule .1961.
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 ❑ M20Line ❑ PWR Line
Following are the specifications for the sewa a disposal
70ther
system on above captioned
property.
Type of system:
❑ Conventional TS%O
�the
/[ x !JU 9-1/115
Septic Tank A39 0 a gallons Pump Tank 0 c5 gallons
Subsurface
No. of
exact length
width of depth of
Drainage Field
ditches 3
of each ditch X00
a
feet ditches 3 feet ditches ZG —?/V inches
French Drain Required: Linear feet
Authorized State nt _ Date 1Z —Z 7
1"HIM, 9101 to]"
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