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OP RHTE# I ) - 5 -a.] V�A(L Harnett County Department of Public Health PERMIT # Operation Permit 22782 New Installation Al Septic Tank Nitrification Line E] Repair El Expansion PROPERTY LOCATION: M s owQ, K'p Name: (owner) WC o, 4 SUBDIVISIONa�l cG LOT # a� System Installer: `%z, 'RR war i Registration # Basement with plumbing: ❑ Garage ,. Number of Bedrooms q Type of Water Supply: ❑ Community Public ❑ Well Distance from well i C) ® feet System Type: 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. This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization rs:nrni LVri U111Vii3: I. Performance: System shall perform in accordance with Rule .1961. 11. 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 conditions, maintenance and reporting. IV. Operation: V. Other. ❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ Following are the specifications for the ewage disposals stem on the above capt ned property. Type of system: ❑ Conventional Other 1i wg0g _ CQ�� Septic Tank: la(3 Q gallons Pump Tank: Subsurface No. of exact length width of depth of Drainage Field ditches t of each ditch 1 feet ditches feet ditches ZA -3 French Drain Required: Linear feet PWR Line gallons inches � i_' �,,... a_1., � �