OPHTE# Harnett County Department of Public Health 2 0 7 5 6
PERMIT # _s2 Operation Permit
New Installation Septic Tank El Repai~`Nitrifcation line 11 Expansion
PROPERTY LOCATION:
Name: (owner) _ SUBDIVISION 0e~ LOT
System Installer: f C ~~r > Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms
Type of Water Supply: ❑ Community is ❑ Well Distance from well -12-2 feet
System Type: ~J - Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner most contact Health Department 6 months prior to expiration for permit renewal.
ims system has peen mstaneo in compliance wan
51-11
North Larolma-heneTal Itatutes, Rules for lewage Treatment and
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and all conditions of the Improvement Permit and Construction Authorization.
PERMIT
1. Performance: System shall perform in accordance with Rule .1961.
II. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ No
If yes, see attached sheet for additional operation
IV. Operation:
V. Other
maintenance and reporting.
Following are the specifications for the se "e disposals stem on the above captioned property.
Type of system: ❑ Conventional Other 1 101.--) Septic Tank: gallons Pump Tank: gallons
Subsurface No. of ~~~111 exact length width of depth of
l -
Drainage Field ditches of each ditch feet ditches feet ditches 11 ' oZ inches
French Drain Required: _ Linear feet
Authorized State Age
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