OPHTE#'I5"5-3"l-) Harnett County Department of Public Health 23983
PERMIT # Operation Permit
New Installation NQeptic Tank X Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: Cot ),- 'Q�35 sOE Q2
Name: (owner) MckLE `AomG5 LZt✓ SUBDIVISION Chaxmarv� LOT #53
System Installer: Coo)r CjPryrrC(� Registration #
Basement with plumbing: ❑ Garage �M Number of Bedrooms L'
Type of Water Supply: ❑ Community 'X Public ❑ Well Distance from well I OO Net
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 statutes. Rules for Sewage Treatment and Disposal and all conditions of the Improvement Permit and Construction Authorization
PERMIT CONDITIONS
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
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System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ N
If yes, see attached sheet for additional operation a
maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑ 112O1-ine ❑ PWR Line
Following are the specifications for the sewage disposal system on the ab gve caption property.
Type of system: ❑ Conventional A Other GsaA�m9G2- Q �H Septic Tank: 1000 gallons Pump Tank S BO gallons
SubsurfaceNo. o exact length width of depth of
Drainage Field ditches of each ditch `'aL) O feet ditches 3 feet ditches 1'9 inches
French Drain Required: ear feet
Authorized State Agent "CIN N� �\\°4.°l Date 5
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