OP RRRHTE#aS-530- aol13ilmz Harnett County Department of Public Health 21 4 7 3
PERMIT # Operation Permit
New Installation Septic Tank ❑ Repair .Nitrification Line ❑ Expansion
PROPERTY LOCATION:
Name: (owner) [j\^ M SUBDIVISION LOT
System Installer: 1 ~+ir4-\ Registration #
Basement with plumbing: ❑ Gara a umber of Bedrooms
~~a, f
Type of Water Sup ly: ❑ Community Public ❑ Well Distance from well 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 app Carolina General Statutes, Rules for
appTicable Carolina General Statutes, Rules for
n ,A,"P-
Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
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PERMIT CONDITIONS:
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
IV. Operation:
V. Other:
Subsurface system operator required? Yes El No 7
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
Following are the specifications for the sewage disposal stern on the above ca ti ned prop rty.
Type of system: ❑ Conventional Other J), . , c (E ; t Ar . 9y f Septic Tank: gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch a.L2 feet ditches ._3 feet ditches inches
French Drain Required: linear feet
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