OPNTE#! 7 5 �S`7� Harnett County Department of Public Health 24782
PERMIT # Z?'�� Operation Perm'
t� New Installation Septic Tank led— Nitrification Line ❑ Repair ❑ Expansion
A ^ PROPERTY LOCATION:Z%T.AJLS�
Name: (owner) ( ayk ffln4 SUBDIVISION aJS Jt;eZt,?L= LOT #,32__
System Installer. Registration #
Basement with plumbing: ❑ Garage � Wmber of Bedrooms -3
Type of Water 5 1 ly: ❑ Community [6 Public ❑ Well Distance from well feet
System Type: �3Types V and VI Systems expire in S years.
(In accordance with Ta le V a) Owne must contact Health Department 6 months prior to expiration for permit renewal.
cep- a ef
This system has been installed in compliance with applicable North Camlina General Statuses, Rules for Sewage Treatment and Dispo d all conditions of the Improvement Permit and Construction Authorizanon.
I. Performance:
If. Monitoring:
III. Maintenance:
IV. Operation:
Other:
54!�b
I
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 ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
❑
D -Box ❑
Pump ❑ Alarm
❑ H2OLine ❑ PWR Line
Following are the
specifications for the sewage disposal
systen on the abov captioned property.
Type of system:
❑ Conventional ❑ Other
Z/
Septic Tank _L0_" gallons Pump Tank: �gallons
Subsurface
No. of
exact length
width of 2 depth of
Field
ditches
�Drainage
of each ditch _0— feet
ditches J feet ditches inches
French Drain Required: Linear feet
Authorized State Agent-- Date —C) —� �
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e
1'/� � �► 1 AI � � 1r
17-5-40978 (1) 17-540978 (2) 17-5-40978 (3) 17-540978 (4) 17-5-40978 (5)
17-540978 (6) 17-5-40978 (7) 17-5-40978 (8) 17-5-40978 (9) 17-5-40978 (10)
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Wk
� 1
17-5.40978(11) 17-5-40978(12) 17-5-40978(13) 17-5-40978(14) •17-540978(15)
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1y 1 � ffi_y
.� �. s t i�1 _.v •tel{ n - ��
17-5-40978(16) 17-5-40978(17) 17-5-40978(18) 17-5-40978(19) 17-5-40978 (20)
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4
17-5-40978(21) 17-5-40978 (22) 17-5-40978 (23)