OP RHTE# - s--- 2-wo -sr-?> Harnett County Department of Public Health
PERMIT # Operation Permit / 2 2 2 7 2
New Installation [Z Septic Tank [ Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:.. ill
Name: (owner) f / C_ SUBDIVISION C.) /3 C s,~ LOT #
System Installer: Registration #
Basement with plumbing: ❑ Garage ❑ yumber of 7w, ms
Type of Water Supply: ❑ Community Public ll Distance from well feet
System Type: Types V and VI Systems expire in 5 years.
(In accordance with Table V a) $ q Owner must contact Health Department 6 months prior to expiration for permit renewal.
PERMIT CONDITIONS:
1. Performance:
ll. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
System shall perform in accordance with Rule .1961. 15U 7- U40 5'Z=' " till`' " - C a y ,a-
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 sewage disposal system on the above captioned property.
Type of system: ❑ Conventional D,Other Z?J6 SO-e- Septic Tank: Z t3 gallons Pump Tank: 10 6 c gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch 1 feet ditches feet ditches Z4 inches
French Drain Required: Linear feet
Authorized State Ag Date 6
C,
11-5-27202R (2)
11-5-27202R (1)
7
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E
M 1
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11-5-27202R (3)
11-5-27202R (4)
11-5-27202R (5)
11-5-27202R (6)