OPHTE# g- '2. Harnett County Department of Public Health
PERMIT # Z Operation Permit 2 2 2 7 5
E2 New Installation Septic Tank 12/ Nitrification Line ❑ Repair ❑ Expansion
tt PROPERTY LOCATION: o i ins ~ d " 16
Name: (owner) 2G f~~' . Ga4% SUBDIVISION LOT #
System Installer: :Id' ~ ?__O CN-) Registration #
Basement with plumbing: ❑ Garage Q/ umber of Bedrooms
Type of Water Supply: ❑ Community L Public ❑ Well Distance from well feet
System Type: 25J a L=opes 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.
Ines system has oeen mstauea in compliance with applicable North Larolma General xatutes, Holes for )ewage Ireatment and
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and all conditions of the Improvement Permit and Construction Authorization.
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PERMIT CONDITIONS:
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 ❑ 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 sewar disposai stem on the above ca tioned property.
Type of system: ❑ Conventional E Other 0526 ~ 6_ ZS ' Septic Tank: 60 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch J O O feet ditches 3 feet ditches inches
French Drain Required: Linear feet
Authorized State Agent' Date '5- ' 2-07 Z
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11-5-26129 (1)
11-5-26129(2)
11-5-26129 (3)
11-5-26129 (4)
11-5-26129 (5)
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9
11-5-26129 (6)
11-5-26129 (7)
11-5-26129 (8)
11-5-26129 (9)
11-5-26129 (10)