OPHTE# - ZZ15-7 Harnett County Department of Public Health
PERMIT # Aperation Pe It 21 7 2 0
New Installation Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATIOv~t
Name: (owner) SUBDIVISION 41eVZ LOT # ~
System Installer: 5 _ Registration #
Basement with plumbing: ❑ Garage umber of Bedrooms 15
Type of Water Su ply: ❑ Community Public ❑ Well Distance from well feet
System Type: l ypes V and VI Systems expire in 5 years.
(In accordance with Table V a) IUD Owner m t 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 196
II. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No
If yes, see attached sheet for additional operation onditions, maintenan a and reporting.
IV. Operation:
V. Other.
❑ D-Box ❑ Pump ❑ - -TAlarm ❑ H201-ine ❑ PWR Line
Following are the specifications for the sewa disposal system on the above captioned property.
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Type of system: El Conventional Other - 'r q4.- ? Septic Tank: gallons Pump Tank: ZOO Q gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch I 4-G- feet ditches
feet ditches X2' Za j inches
french Drain Required: Linear feet
Authorized State 19zCPA-'10"~ Date
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