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OPHTE# ~1-5, a. 15) Harnett County Department of Public Health PERMIT # aLOperation Permit 2 21 4 5 New Installation X Septic Tank Nitrification Line ❑ Repair ❑ Expansion PROPERTY LOCATION: `1irJ6 a Qp Name: (owner) 9t) o L-L.. C.--p\c-L-r- \N® MC SUBDIVISION f p; t-So,,\s Pox,-F-~- LOT # 3 6 System Installer: L_;vg,c -j SSA ,aLP Registration # Basement with plumbing: ❑ Garage Number of Bedrooms Type of Water Supply: ❑ Communi Public El Well Distance from well 100 feet System Type: Types V and VI Systems expire in 5 years. (In accordance with Table V a) 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. to VJ P , I 1 2t og, ( >2I-- j I , -r, ~ ~ t 'C'aoA pm m 7+ F,D R 3~r nrnurc r-mltlnur. - 1 Lnilll WiluI IIVI\J. 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 ❑ NoX 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. Type of system: ❑ Conventional ')4 Other PL)PN9 l o Q `G~lar+~ Septic Tank: 1000 gallons Pump Tank: L©GCJ gallons Subsurface No. of exact length width of depth of Drainage Field ditches of each ditch a00 feet ditches feet ditches 1`3 `aZ-} inches French Drain Reauita--_ s e,feet Authorized State Agent ~~V~" - ~C-t,S Date -Vol 4 % f f a. t 7 ,4v kr Y ! [t r~ ; ~i y" L[F€ , E y~ ism, ` ~~y rO ~Ii✓ ~ K EJ a ~ i f'c Y/'/ r ~ r b , t L - Al f Yv k ~4 IE a F yr; i t w ~ F w ap i 1'