OP RHTE# 0n 5-Do- ;t>~ -/!:>a Harnett County Department of Public Health 90741
PERMIT #7~ Operation Permit
.New InstallationC~eptic Tank ❑ Repaj5~4~ iNitrification line ❑ Expansion
PROPERTY LOCATION:
Name: (owner) SUBDIVISION e2_<;( 12 n c~~}rv An LOT # e~
System Installer. enr c) Registration #
Basement with plumbing. ❑ Garage tiR- Number of Bedrooms
Type of Water pply: ❑ Community Public ❑ Well Distance from well ZiJ feet
System Type: Types V and VI Systems expire in S years.
(In accordance with Tab e V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
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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 ❑ jNo
If yes, see attached sheet for additional operamaintenance and reporting.
Following are the specifications for the s;;n disposal sys on the above capti ned grope [A N
Type of system: ❑ Conventional ther ~!1 r Septic Tank gallons Pump Tank: 0 gallons
Subsurface No. of exact length width of depth of
Drainage field ditches _ of each ditch feet ditches- feet ditches- inches
French Drain Required: _ Linear feet
Authorized State Agent i G ~ q Date J(X - 12 • 0 ~
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