OPHTE# IS Harnett County Department of Public Health 24076
PERMIT #7S Operation Permit
New Installation �R Septic Tank )X Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: T
Name: (owner) es,a _ CL,rat" �AoN-Tz:, SUBDIVISION JP"7- 0 LOT # 1
System Installer: VJfky"E—::Z ,f,5 Registration #
Basement with plumbing: ❑ Garage XNumber of Bedrooms 3
Type of Water Supply: ❑ Community -19. Public ❑ Well Distance from well 100 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 Statutes, Rules for Sewage Treatment and DisposaL and all conditions of the Improvement Permit and Construction Authoritarian.
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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 ❑ No
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
❑ D -Box
❑ Pump ❑
Alarm ❑
H2OLine ❑ PWR Line
Following are the specifications for
the sewage disposal system on the above tion roperty.
Type of system: ❑ Conventional
Other C.HS�,.ns�E;Z �&
Septic Tank: �ZS�
gallons Pump Tank: gallons
Subsurface No. of
exact length
width of
depth of
Drainage Field ditches
of each ditcAa feet
ditches 3
feet ditches inches
French Drain Required: —�._.
Linear feet
Authorized State Agent fr6y�s Date
HTE# ��� ��h-1 Harnett County Department of Public Health
PERMIT#7S Operation Permit
New Installation Septic Tank ❑ Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATIO(N]:
Name: (owner) �Ta �l c�r� L tioRn SUBDIVISION 'Pt, to r.as >>. LOT # I
System Installer: 'Of -vie Registration #
Basement with plumbing: ❑ Garage"W Number of Bedrooms 3
Type of Water Supply: ❑ Community =P), Public ❑ Well Distance from well 1 (7""? feet
System Type: "rz c, 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 applimble Nonh Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Constmaion Authorization
rcnrni wnuniuns:
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
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yl �
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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 ❑ No
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
❑ D -Box ❑ Pump ❑ Alarm ❑
Following are the specifications for the sewage disposal system on the above ca tinned property.
Type of system: El Conventional 1)0Other❑.�1z.�� •�Gl 1711 Septic Tank:
Subsurface No. of exact length - width of
Drainage Field ditches of each ditA`3 Q feet ditches
H20Line ❑
PWR Line
_ gallons Pump Tank gallons
depth of
feet ditches ��;rj�� inches
French Drain Required: Linear feet
Authorized State Agent r4�- -15 Date 5 !1; f