OPHTE#Harnett County Department of Public Health 20530
PERMIT # Operation Permit
New Installations Septic Tank ❑ RepairX Nitrification Line ❑ Expansion
PROPERTY LOCATION:
Name: (owner) RAM ~~~~zOPM~~ SUBDIVISION Cp%=L-N-P, QA LOT # 63
System Installer. W~.~►w~-SC,~,FS Registration #
Basement with plumbing: ❑ Garage '15~r, Number of Bedrooms _-3
Type of Water Supply: ❑ Community ;R~ Public ❑ Well Distance from well LoU feet
System Type: ZL~ 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.
Ims system nas peen mstanea in compliance vnth applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
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1. Performance:
11. Monitoring:
111. Maintenance:
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other.
IV. Operation:
V. Other.
Subsurface system operator required? Yes ❑ NO
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: X Conventional El Other
Subsurface No. of exact length
Drainage Field ditches _ of each ditch _ oO feet
French Drain Required--,- \
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Septic Tank: VnCOQ gallons Pump Tank: gallons
width of depth of
ditches 3 feet ditches- inches
Authorized State Agent v ~-'`!~~S Date 3.
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