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OP RHTE# /5-5—)7L 7/ PERMIT # Name: (owner) Cp D�t� System Installer: �-1d4 Basement with plumbing: ❑ Type of Water Supply: ❑ Cm System Type:r (In accordance with Table V a) Harnett County Department of Public Health 24122 Operation Permit mew Installation L Septic Tank Nitrification Line, ❑ epair El Expansion PROPERTY LKATION: d1, aj qAi fry fJfy! MhA ft� )I, -.e 5 SUBDIVISION 61l�p.ed 'W©",d c LOT Registration # Ot; Garage 13`Num6er of Bedrooms_, unity ublic El Well Distance from well _)L �A- feet Ldt 1*1 T�Aa2 lit% Types V and VI Systems expire in 5 years. yy�j,Q,Y Owner must contact Health Department 6 months prior to expiration for permit renewal. This moria hm hits, In,mbd in r..nlinnrt with ... Im hl. Nnrrh famlin. f..—I Innim, Md., t.. s.— T— .... ...a n:...... ..� ..,.. �nl111 wnmllvn J. I. Performance: If. Monitoring: III. Maintenance: IV. Operation: V. Other. P-11 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 disposal s ste orl�h ,above Palo d property. Type of system: El Conventional Conventional Other 7 (Y� / 0- Septic Tank: Subsurface No. of L.� exact len? [ width of Drainage Field ditches / of each ditch V feet ditches H2O1-ine ❑ PWR Line _ gallons Pump Tank gallons depth of feet ditches -.1--inches French Drain Required: linear feeett}y Authorized State Age6E -- ef J rL Date -7-t2-/(o ,.__.. _._ _. _ _ c'F 38- _._ ....�._. _.._....-...... _....... ... .... —..........., lyra 6 . (95 s /v'.C/ No w l->r7te+ �`.ts lP�,i1 A+ At's mak. l -Xzjw s oke4t-aog i-� 6� ye ,hyo NL �nl111 wnmllvn J. I. Performance: If. Monitoring: III. Maintenance: IV. Operation: V. Other. P-11 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 disposal s ste orl�h ,above Palo d property. Type of system: El Conventional Conventional Other 7 (Y� / 0- Septic Tank: Subsurface No. of L.� exact len? [ width of Drainage Field ditches / of each ditch V feet ditches H2O1-ine ❑ PWR Line _ gallons Pump Tank gallons depth of feet ditches -.1--inches French Drain Required: linear feeett}y Authorized State Age6E -- ef J rL Date -7-t2-/(o