OPHTE#d/-5_-- 65Harnett Lounty Department of Public Hea,ch
PERMIT # 26 Operation Puma 21 7 4 2
New Installation IX Septic Tank V Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: YL// ' b~
Name: (owner) ¢ SUBDIVISION LOT #
System Installer: Registration #
Basement with plumbing: ❑ Garage ❑l Number of Bedrooms 61-
Type of Water Supply: ❑ Community LI Public ❑ Well D tance fro w feet
System Type: Types V and VI Systems expire in 5 years.
(In accordance with Table V a) _ rper must contact Health Department 6 months prior to exoration for permit renewal.
This system has been installed in compliance with applical
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and all conditions of the Improvement Permit and Construction Authorization.
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PERMIT CONDITIONS:
1. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
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.
V. Other:
❑
D-Box ❑
Pump ❑ Al
arm ❑ H20Line ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property .
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Type of system:
El Conventional C Other
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' Se tic Tank: OCR gallons Pump Tank: gallons
Subsurface
No. of
y
exact length
width of depth of
Drainage Field
ditches
of each ditch 5-0 feet
ditches feet ditches I te inches
French Drain Required: Linear feet
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Authorized State A Date
North Carolina General Statutes] Rules for Sewage Treatment
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