OPHTE# 15 -5- 3G44b Harnett County Department of Public Health 23825
PERMIT# Operation Permit
New InstallationSep is Tank )0 Nitrification Line El Repair ❑ Expansion
PROPERTY LOCATIO : EP.NvT LrJ
Name: (owner) NA 1 �4 O NS ',s SUBDIVISION LOT # �
System Installer: s s S -s aw c i—ta , P Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms 3
Type of Water Supply: ❑ Community -K Public ❑ Well Distance from well S O O feet
System Type: = Types V and VI Systems expire in S 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 Statute; 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.
II. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ Max
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PAIR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional Other G Z Septic Tank: t eh nQ gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ifil L of each ditch %gas feet ditches 3> feet ditches �'!�_ inches
French Drain Required: Linear feet
Authorized State Agent NIS __Z \RST hs Date c