OP RHTE# \5-5 --1-1 1 y Harnett County Department of Public Health 24017
PERMIT # _ Operation Permit
New Installation Septic Tank �D< Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: Qg�vt3
nce
Name: (owner) iY%<.�oE \-i"-a )LNG SUBDIVISION C)P y-joaaC LOT # S�—
System Installer: EsA\E Co as eaGCL Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms 4
Type of Water Supply: ❑ Community Public ❑ Well Distance from well C) feet
System Type: d 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 Went Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Wnstrurdon Aumon:atwn.
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PERMIT CONDITIONS:
I. Performance:
11. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ No
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
❑
D -Boz
❑ Pump ❑
Alarm ❑ H2OLine ❑ PWR Line
Following are the
specifications for
the jewage disposal system on the abovg
caption�d property.
Type of system:
❑ Conventional
Other �' �a (if rL ���
1
Septic Tank: V60 gallons Pump Tank: gallons
Subsurface
No. of
exact length
width of depth of
Drainage Field
d' hes
T of each ditch
300 feet
ditches 3 feet ditches r? inches
French Drain Reauired`
Linear feet
a&�ow m0,rVC 04. r.WD6
Authorized State AnentN� `y�,�� ?L -r'6 Date 5
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