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OP RHTE# I~ = = PvI IZ- Harnett County Department of Public Health PERMIT # Vlle) Operation Per pt 21 7 3 5 IQ New Installation Septic Tank Z--'Nitrification Line ❑ Repair ❑ Expansion Name: (owner)jg-y,-~c1~ System Installer: X i ;VkOL'Ao Basement with plumbing: ❑ Garage ❑ umbE Type of Water Supply: ❑ Community Public Public Well Distance from well !d-p feet System Type: LS°l,~ (In accordance with Table V a) PROPERTY LOCATION:~,1-7,Z l~ 17-YO SUBDIVISION , .,9 lei LOT # ~ Registration # r of Bomoms .3 Types V and VI Systems expire in 5 years. 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 I' Mil LUNDIIIUNS: 1. 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 ❑ 1-1201-ine ❑ PWR Line Following are the specifications for the sews,ge disposals stem on the above captioned prope k Type of system: El Conventional OthergltY zl Se tic Tank: gallons Pump Tank: gallons Subsurface No. of exact length width of depth of Drainage Field ditches of each ditch ©d feet ditches 3 feet ditches -77" inches French Drain Required: Linear feet Authorized State A Date `ate" Z1- jt ~ ~ ~ ,S ~ N e ~ N ~ ~ . ~ ~ ~ S.. ' ° " ~1