OP RHTE# ')(L Harnett County Department of Public Health
PERMIT Operation Permit 22809
New Installation IN, Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOfATION: o
Name: (owner) 's'r rr Cora-, —,s Nj c , :N V rJ SUBDIVISION gL0n ..c?� �'.� ®t� LOT # �
System Installer: 11-4 os a 1P ti— u n.e')r'� 6 Registration #
Basement with plumbing: ❑ Garage, Number of Bedrooms
Type of Water Supply: ❑ Community Public ❑ Well Distance from well E ®V 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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PERMIT CONDITIONS:
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:
Following are the
Type of system:
Subsurface
Drainage Field
French Drain Rea
Authorized State
D -Box ❑ Pump ❑
cations for the sewage disposal system on the above captioned property.
raven ' t �Ieng�th No. of `ctditches feet
Alarm ❑
Septic Tank: f SQ®
width of
ditches 3
2Gmss Date
H2OLine ❑
PWR Line
gallons Pump Tank: 10p� gallons
depth of
feet ditches inches