OP RHTE#-0 >1 sue' Harnett County Department of Public Health 2 0 6 3 6
Type of Water Supply: ❑ Community 'K Public ❑ Well Distance from well l-',, - feet
System Type: e. Z FI L-+ V;~' S~- 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.
PERMIT #7 Operation Permit
New Installation ig Septic Tank ❑ Repair-l Nitrification Line ❑ Expansion
PROPERTY LOCATION: 1123-
Name: (owner) 'Jlrl~~wc~li, `'~~McS SUBDIVISION L,J~ Stt.n ` LOT # 223
System Installer: 0. S 2 , (z \ d Registration #
Basement with plumbing: ❑ Garage 'KI Number of Bedrooms
ims system naS oeen mstaneb in compuance wim applicable north t.arolina beneral ltatutes, Rules for kwage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
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1. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring: As required by Rule .1961.
111. 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.
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional T2V-Other Z irk Ot, Septic Tank: J`JJ gallons Pump Tank: gallons
Subsurface No. of exact length / width of depth of
Drainage Field ditches T of each ditch I VJ feet ditches _2 feet ditches -~4' 24 inches
French Drain Required: Linear feet
Authorized State Agent Date 3 ~ °I
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