OP RHTE;c--aaI2 Harnett County Department of Public Health
20826
PERMIT # a Sol 14 Operation Permit
New Installation 'K Septic Tank ❑ Repair Nitrification line ❑ Expansion
PROPERTY LOCATION: StiEa~t~c~s ~~r.e5 ~Q
Name: (owner) \J , p)E.LTocj SUBDIVISION S,,A czr^~..1 P~N~S LOT # 1"j
System Installer: ANC. E v 6czr ~~.1 Registration #
Basement with plumbing: ❑ Garage 'X Number of Bedrooms L
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Type of Water Supply: ❑ Community )~Z Public ❑ Well Distance from well too 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.
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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 ❑ NoX
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other. Tav AS C~Kbn CSC a N to oq PuMF Q LA ,J. S S. :-~d gr-
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Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional Other 1? 4 10 E-Zrr ti cri, Septic Tank: tooo gallons Pump Tank: twos gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 3, of each ditch S1-5 feet ditches feet ditches 1$ inches
French Drain Required: near feet
Authorized State Agent 5 Date `1 0
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