OPHTE# Ij--j- L-ig!i 't Harnett County Department of Public Health
PERMIT Operation Permit 2206
® New Installation ❑ Septic Tank ❑ Nitrification Line ❑ Repair Expansion
PROPERTY LOCATION:_
Name: (owner) SUBDIVISION LOT #
System Installer: a° Registration #
Basement with plumbing: ❑ Garage L~ . umber of Bedrooms -J
Type of Water Supply: ❑ Community Lf Public ❑ Well Distance from well feet
System Type: Types V and VI S stems ex ire in 5 years.
(In accordance with Table V a) Owner must contact at
5e rtn rit 6 months p 'or to expiration for permit renewal.
This system has been installed in compliance with applicable North Carolina General Statutes Rules for Sewage Treatme
Permit and Construction Authorization.
and all conditions If the
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PERMIT CONDITIONS:
I. Performance:
II. Monitoring:
III. Maintenance:
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System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other:
IV. Operation:
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
V. Other:
❑ D-Box ❑ Pump ❑
Following are the spe cations for the sewage disposal system on the above captioned property.
Type of system: 1'1 Conventional ❑ Other
Subsurface No. of exact length
Drainage Field ditches of each ditch Z feet
French Drain Required: Linear feet
Alarm ❑
H2OLine ❑
PWR Line
I27~c`>
Septic Tank: F--xx:s gallons Pump Tank: gallons
width of depth of
ditches feet ditches inches
Authorized State , Date `°I'L1
77 7'
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11-5-27400 (6) 11-5-27400 (7) 11-5-27400(8)