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HomeMy WebLinkAboutOPHTE# O °1Harnett County Department of Public Health 2 0 81 9 PERMIT # as3 Operation Permit New Installation 'N Septic Tank ❑ Repair>< Nitrification Line ❑ Expansion PROPERTY LOCATION: Lcd,~' Eo. '9-p Name: (owner) SUBDIVISION W t~v°t C-,Qr,vC~, LOT #1d System Installer. Registration # Basement with plumbing: ❑ Garage `i Number of Bedrooms t_► Type of Water Supply: ❑ Community Public ❑ Well Distance from well 100 feet System Type: 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. MIS 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. C) 0, P \ Na NO t t 1 Pia; \ bs., iQ6A~ \ t2.EPA~Q \ \ N ~ f Rb~.Ral~ L MMIT rALIn ITIALIf. 1. Performance: II. Monitoring: III. Maintenance: IV. Operation: V. Other. 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 5Y"5's~t~I pt) F is A„t5rsr. G~Lc,, _,y~ ~-t c7'C W A'c(~ 6•.,6n, 1_1 v E. ~ sLL "(o Q ~ ~ Eft. G Following are the specifications for the sewage disposal system on the above captioned property. Type of system: ❑ Conventional L~ Other 1=-2-Fi. , , Septic Tank: 000 gallons Pump Tank: /©©0 gallons Subsurface No. of exact length width of depth of Drainage Field ditches of each ditch 3 00 feet ditches q feet ditches to inches French Drain Required: Linear feet I Authorized State Agent 3J,akt Jaj'-Izidari, e'~l s Date /0z"0 429 I a Inj If? - n ~ ~y~r y ripp. 3 -iC w O `1- 5 ~3 _ w? S S y' Y t r~ 1 i3 n t s ~y ~ L`Cj~,' ■ry t. } t r # o~ f ; i t « 1 z 4 ^k 4 INS max` Ni,%- - . 0C►-15 --Q-