OPHTE# /I--5;--26ZZS Harnett County Department of Public Health
PERMIT Operation Permit 22067
New Installation 2 Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LO(ATION ` 1g,3°J
Name: (owner) 5./ SUBDIVISION LOT # Z
System Installer: eat ,c Registration #
Basement with plumbing: ❑ Garageumber of Bedrooms
Type of Water Supply: El Community I~ Public ❑ Well Distance from well feet
System Type: 2506 12J~b .Sf_g 4- 1~kef 'X-Q, Types V and VI Systems expire in 5 years.
(In accordance with Table V~ Owner must contact Health Department 6 months prior to expiration for permit renewal.
ims sysrem nas peen mscanea in compuance w¢n appncaDle norm Lamina beneraT xatutes, awes for )ewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
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rtn1911 l.unuMM:
1. Performance: System shall perform in accordance with Rule .1961.
11. 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 ❑ 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 1 Other ? / , C~~~t f
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Septic Tank: 4) ~ gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch -t U feet ditches 3 feet ditches inches
French Drain Required: Linear feet
Authorized State AJZ)e9,na0 4~1 14"v"4a Date 3 ( i
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-TI /Vue
4
11-5-26225 (8) 11-5-26225 (1) 11-5-26225 (2) 11-5-26225 (3) 11-5-26225 (4)
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11-5-26225 (5) 11-5-26225 (6) 11-5-26225 (7)
11-5-26225 (4) 11-5-26225 (5)
11-5-26225 (6)
11-5-26225 (7) 11-5-26225(8) 16076 001