OPHTE# 1-7-5-L►ao-i i Harnett County Department of Public Health 25037
PERMIT # a Ts Operation Permit
New InstallationExair ❑ Se tic Ta Nitrifi tion Line ❑ Re anion
PROPERTY LOCATION: i. e H vc:t U� P P
Name: (owner) 0>—, E V 6 )—I omcs SUBDIVISION LOT #
System Installer: ' rTr2K . / Tel Psw zcs Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms
Type of Water Supply: ❑ CommKjy Public ❑ Well Distance from well feet
System Type: )—)—L c 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 (andma General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorisation
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PERMIT CONDITIONS
I. Performance: System shall perform in accordance with Rule .1961.
11. 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.
❑
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❑ Pump ❑ Alarm
❑ H2OLino ❑ PWR Line
Following are the specifications for
the sewage disposaletem on the above wptioned�roperty. 9
GTS- 1poo STe. rc3
Type of system:
❑ Conventional
Other x� e,eaBEn— ��`
Septic Tank: 1068 gallons Pump Tank: gallons
Subsurface
No. of
exact length
width of depth of
Drainage field
ditches
s of each ditch X60 feet
ditches 3 feet ditches 14� inches
french Drain Required: Linear feet
Authorized State Agent �� QG Date 31a
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