OPIITE# 1-�-5'1+TO Harnett County Department of Public Health 24906
PERMIT # Q26-7 `1 Operation Permit
New Installation )� Septic Tank A Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: Q(3 aofttcxSA
Name: (owner) SUBDIVISION raEn�,P vo Yto� `LS SUBDIVISION C.pcwy -\aA AY1R1S LOT # 33
System Installer Iso 162v� Registration #
Basement with plumbing: ❑ Garage ",Number of Bedrooms N
Type of Water Supply: ❑ Community �K Public ❑ Well Distance from well feet
System Type: =Q;Z Types V and VI Systems expire in 5 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 Scatter, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and tonstrumon Authorization
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PERMIT CONDITIONS
I. Performance: System shall perform in accordance with Rule .1961.
ll. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ NOX
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
❑
D -Box
❑ Pump ❑ Alarm ❑
H2OLine ❑ PWR Line
Following are the
specifications for
the sewage disposallss tem on the above/ caption e roperty.
Type of system:
El Conventional
f� Other 1!711 CSL l uX� Septic Tank: 10015
gallons Pump Tank: gallons
Subsurface
lo. of
exact length width of
depth of
Drainage Field
ditches
l of each ditch ').D0 feet ditches 3
feet ditches inches
French Drain Required: _
_ \ Linear feet
Authorized State Agent 'S5 Date al31g
i -r 5 Lj�`7�50