OPHTE# JVa�S-'-t Harnett County Department of Public Health
PERMIT # Operation Permit 22764
New Installation 'CR,, Septic Tank X Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: �'�� QD
Name: (owner) savvy �o�^ES SUBDIVISION V—E g \5 LOT # Zi-3
System Installer: NA E9-1 � e- Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms
Type of Water Supply: ❑ Community Public ❑ Well Distance from well �d® feet
System Type: 1 1 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.
PERMIT CONDITIONS:
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
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.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: El Conventional � Other Septic Tank: X000 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditcc -- f of each ditch feet ditches 3 feet ditches inches
French Drain Required: I meet
Authorized State pent 1;� Date
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