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OPHTE# ) f -.5- - Z Harnett County Department of Public Health PERMIT .'Operation Permit 2 2 0 8 8 New Installation Ca"'Septic Tank LNitrification Line ❑ Repair ❑ Expansion PROPERTY LOCATION: '61t, I tl to & a 6 r; W Name: (owner) SUBDIVISION IK LOT # 3 System Installer: Registration # Basement with plumbing: ❑ Garage © ,,Number of Bedrooms Type of Water Supply: ❑ Community ® Public ❑ Well Distance from well feet System Type: ?,5% W6WVr_(1 T_.~ ~ 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 Carolina General Statutes, Rules jy Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization PERMIT CONDITIONS: 1. Performance: II. Monitoring: 111. 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 ❑ No ❑ If yes, see attached sheet for additional operation conditions, maintenance and reporting. ❑ D-Box ❑ Pump ❑ _ Alarm ❑ H20Line ❑ PWR Line Following are the specifications for the s a disposal system on the abov~ c` ti~lied,oP Type of system: El Conven ewa tional Other -59. 5 2,1W 3 4 .16 14 - Septic Tank: 1 P gallons Pump Tank: gallons Subsurface No. of exact length width of depth of Drainage Field ditches of each ditch f_2>G~> feet ditches 3 feet ditches inches French Drain Required: Linear feet ~~r Authorized State Went A(. Date 17 ' ILA ` I 1 11-5-27637 (7)