OPHTE# I, -s- L4 10311- Harnett County Department of Public Health 24915
PERMIT # y11� Operation Permit
New Installation R Septic TankNitrification Line ❑ Repair ❑ Expansion
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PROPERTY LOCATION: W s LL 1,Vrk
Name: (owner) L_PSAe— Coass.0 . IN c— SUBDIVISION wtdot_ LOT # 5
System Installer. NeagDltJ 561011 L Registration #
Basement with plumbing: ❑ Garage �9 Number of Bedrooms
Type of Water Supply: ❑ Community �X Public ❑ Well Distance from well feet
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
1. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring: As required by Rule .1961.
111. 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:
Other.
❑ D -Boz ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal s� stem o,R..the above captioned property.
Type of system: ❑ Conventional Other E!T VL-OVSeptic Tank 1 6 O gallons Pump Tank: gallons
Subsurface \ No. of exact length ti width of depth of
Drainage Field at35 of each ditch feet ditches feet ditches �� y,—F inches
French Drain Required: \�ear feet
Authorized State Agent RobyS Date DL
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