OP RHTE# 37 - Harnett County Department of Public Health
PERMIT # 20tj{ i5j /Operation Pe *nit 21750
❑ New Installation Septic Tank ❑ Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: 4
Name: (owner)~i~'~~t(~d'r SUBDIVISION LOT #
System Installer: Q h,r~ Registration #
Basement with plumbing: ❑ Garage ❑ umber of Bedrooms
Type of Water Supply: ❑ Community L Public ❑ Well Distance from well feet
7 ` t huli~Tt° P`c: Types V and VI Systems expire in 5 Years.
System Type: L
~ (In accordance with Table V a) 7 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
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PERMIT CONDITIONS:
1. Performance: System shall perform in accordance with Rule .1961. t
ll. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No. ❑
IV. Operation:
V. Other:
If yes, see attached sheet for additional operation conditions, maintenance d reporting!
❑ D-Box ❑ Pump ❑ Alarm ❑ H20Line ❑ PWR Line
Following are the specifications for the sew a disposal s stem on the above captioned property.
Type of system: El Conventional 54 Other sO;~~-w, AZI-e- S~ept~Tank: gallons Pump Tank: gallons
Subsurface No. of exact length width of _ depth of
Drainage field ditches ~ of each ditch 15-0 feet ditches ~ feet ditches 2Y inches
French Drain Required: Linear feet
Authorized State e ~--c..- ~ ~ ~ h~•~---~ ~ Date
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11-5-26245R (11)
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