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OPHTE# 4 - Z6-IZ Harnett County Department of Public Health PERMIT Ope-r-ati n P -mit 22081 E/New Installation IJ Seotic Tank /Nitrification Line ❑ Reuair ❑ Exuansion PROPERTY LOCATION: IW3_7 i3c4C Name: (owner) 57-A1 3W FA~ Di _1z42:,. SUBDIVISION ~ i,-- LOT # 35- System Installer: Sa Registration # Basement with plumbing: ❑ Garage Number of Bedrooms 5 Type of Water Supply: ❑ Community © Public ❑ Well Distance from well feet System Type: 61/cyy{ C- 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. This system has been installed in compliance with applicable North larolma beneral )tatutes, hules for Ireatment am! Ulsposal, and an conaltlons of the improvement rermit ana lonstruction Aumorizatlon. 5> PERMIT CONDITIONS: 1. Performance: System shall perform in accordance with Rule .1961. 11. 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 conditions, maintenance and reporting. IV. Operation: V. Other: ❑ D-Box ❑ Pump ❑ Alarm ❑ H20Line ❑ PWR Line Following are the specifications for the sew a disposal system on the above captioned properyV~ Type of system: ❑ Conventional Other Z5'04 S t Septic Tank: 10 00 gallons Pump Tank: gallons Subsurface No. of exact length I width of depth of Drainage Field ditches 3 of each ditch D feet ditches 3 feet ditches inches French Drain Required: Linear feet Authorized State Age Date t I- a ktbLWPt Iris a'7.7y..._.. E 11-5-26228 (1) 11-5-26228 (2) 11-5-26228 (3) 11-5-26228 (4) 11-5-26228 (5) a 11-5-26228 (6) 11-5-26228 (7) r n. 1 it? 4 yTr'n 1 11-5-26228 (1) 11-5-26228 (2) 11-5-26228 (3) 11-5-26228 (4) 11-5-26228 (5) 11-5-26228 (6) 11-5-26228 (7)