OPHTE# I -y33 Harnett County Department of Public Health 24988
PERMIT # Id 92 0weration Permit
Lf?'New Installation C�ieptic Tank 2 -'Nitrification line ❑ \Repair EJ Expansion
PROPERTY LOCATION: 1543 rCc� N, II <-hurd, 2GeaC i5rt I Li3>
Name: (owner) fL ugsSUBDIVISION LOT # 3
System Installer: C.1%n-L,n (7—nc,,A SerrE;c.- Registration #
Basement with plumbing: ❑ Garage ❑ "r of Bedrooms 3
Type of Water Supply: ❑ Community &KPublic ❑ Well Distance from well feet
System Type: 5"u 6Types V and VI Systems expire in S years.
(In accordance with Table V a) wner must contact Health Department 6 months prior to expiration for permit renewal.
IMS system on been imtaned to mmphance with applicable North Carolina General Statutes, Rules Jor Sewage Treatments and Disposal, and all conditions of the Improvement Permit and Construction Authorization
PERMIT CONDITIONS
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
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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.
❑ D -Boz ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage ' posal system on the above captioned property.
Type of system: ❑ Conventional Other 24 \e,= M"— Septic Tank:�c x� gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches .3 of each ditch 9 C7 feet ditches 3 feet ditches inches
French Drain Required: Linear feet
Authorized State AlzentDate 0C-
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