OPHTE# \7 -S—L\d696 Harnett County Department of Public Health 24893
PERMIT #'a`E`aa� Operation Permit
New Installation �K Septic Tank Nitrification Line El Repair L1Expansior
PROPERTY LOCATION: Pna�eee `_" acc,cAA q -o
Name: (owner) SUBDIVISION Ve �ca1 w :T-,. LOT #
System Installer. G->•) 2:,enelvmaF— Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms 3 .R,t,ea vEn.r., asaFit�
Type of Water Supply: ❑ Community ❑ Public 'K Well Distance From well s 00 feet uFyL pry_
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 Statutes, Rules for 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.
II. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ NOA
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other. Sri— �ELi QF[j a,\ rz aa_L \464) \N 5:62n o.51 a a.s
❑
D -Boz
❑ Pump ❑ Alarm ❑
H2OLine ❑ PWR Line
following are the
specifications for
the sewage disposal on the above captioned property.
Type of system:
El Conventional
,sl1.stem
Other Gam- Fa vo - Septic Tank: 1000
gallons Pump Tank: gallons
Subsurface
No. of
3 exact length width of
depth of
Drainage Field
ditches
9 D
of each ditch feet ditches 3
feet ditches 01{"--�6 inches
French Drain Required:
Linear feet
Authorized State Agent Date C>1 ) 1i 19 o t o
e
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