ETHTE 12-5-28125
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Lawrence Curtis Phone 919-708-2316
Address: P.O. Box 1133 Broadway, NC 27505
Name of Mobile Home Park or S/D: Hollies Pines lot 3
Name of Owner (if different): Rick T. & Hodges
Address of Owner (if different): 146 Ridgeford Lane Broadway, NC 27505
Property Location (State Road name and Hollies Pines
Purpose of Inspection: Addition on Deck
The aforementioned site has been evaluated by the Harnett County Health Department
Environmental Health Section. At the time of inspection, there appeared to be a septic
system serving this site. If the system should malfunction, the owner is responsible for any
necessary repairs.
THIS INSPECTION IS VOID IF:
1. the intended use of the septic system should change, and/or
2. the system should fail or malfunction, and/or
3. the owner or tenant of the property change, and/or
4. after six months
BUILDING MUST BE 5' FROM ANY PART OF SEPTIC SYSTEM
DO NOT DRIVE OR PARK ON SEPTIC SYSTEM
AUTHORIZATION OF EXISTING SYSTEM
/Q- /z°/ 2-
of Envronmental Health Specialist Date