OP RRHTE#b-i -5 1 ( -IQa Harnett County Department of Public Health
PERMIT # Operation Permit 21 8 3 4
New Installation A Sufic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: Name: (owner) Tov- SUBDIVISION " ~v-^,-4 9 LOT #
System Installer: 0-, L-0C--5 Registration #
Basement with plumbing: ❑ Garaged, Number of Bedrooms
Type of Water Supply: ❑ Community Public ❑ Well Distance from well i<DC feet
System Type: .ID, 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.
PERMIT CONDITIONS:
1. Performance:
Il. Monitoring:
III. Maintenance:
IV. Operation:
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ Nox
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
V. Other:
❑ D-Box ❑ Pump ❑ Alarm ❑ H20Line ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional V Other F Z I j-6°,/ Septic Tank: s ® gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch 1 feet ditches 3 feet ditches inches
French Drain Reauired'~, 4near feet
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