OPHTE# �-7-S-y0-1 lW, Harnett County Department of Public Health 25048
PERMIT # Operation Permit
New Installation 'N Septic Tank X Nitrification Line ❑ Repair ❑ Expansion
r PROPERTY LOICATION: 411A M s a ys "oy s tr Xaw
Name: (owner) KunaEf l UALSeiLKT$t SUBDIVISION LOT #
System Installer. Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms Q.
Type of Water Supply: ❑ Community ,K Public El Well Distance from well feet
System Type: �3I2� 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.
ims system BE oven mstimn in compnance mm appucame norm sarouna beneml xamtes, Rules tor kwaAe Ireamrent and ersposal, and all mndmons of the Improvement Permit and Construction Authorization.
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rtxnu tuaumons:
I. Performance: System shall perform in accordance with Rule .1961.
If. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ NOX
W. Operation:
V. Other.
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
❑
D -Box ❑
Pump ❑ Alarm ❑
1-1201.ine ❑ PWR Line
Fallowing are the
specifications for the sewage disposal s
stem on, y above captioned property.
Type of system:
El Conventional Other
Z— i.0`M Septic Tank:
gallons Pump Tank: gallons
Subsurface
No. of
exactlength width of
depth of
Drainage Field
ditches
of each ditch 5 feet ditches 3
feet ditches inches
French Drain Featured: _ Linear
feet
Authorized State A¢ent _9:75 Date
I
Map"
1 .1
1-)-5•i-1O-71
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