OP RHTE# I r,-5--1,01,411 iL, Harnett County Department of Public Health 24898
PERMIT # aj i 7, Operation Permit
I New Installation -t Septic Tank ❑ Nitrification Line ❑ Repair ❑ Expansior
PROPERTY LOCATION: GN
Name: (owner) 0f+�Av5rE komc S LLC— SUBDIVISION WaL.Wv" Cgvv& LOT # —A
System Installer. v,r,�G�{L Registration #
Basement with plumbing: ❑ Garage 1KNumber of Bedrooms
Type of Water Supply: ❑ Community 'L Public ❑ Well Distance From well feet
System Type: "Ma -10 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
rurni LURDIIIUNI:
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
El
9-';-gVk,2 ^ t
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.
SEE Data A",t., oe Son. ice. 'P2 F'AL nRWy'at. SiC.G, F,c.?�i IONG
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❑ Alarm ❑
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional ❑ Other
Subsurface No. of exact length
Drainage Field ditches of each ditch feet
H2OLine ❑
PWR Line
Septic Tank 11600 gallons Pump Tank 100a gallons
width of depth of
ditches feet ditches inches
trench Drain Required' Linear feet
Authorized State Agent Date 1 hal 4