ETHTE 12-5-28179
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Clinton Johnson Phone 919-842-1844
Address: 241 Oma Kelly Lane Broadway, NC 27505
Name of Mobile Home Park or S/D: Willett Acres lot 5A
Name of Owner (if different): Steve Willett
Address of Owner (if different): 471 Doyle Cox Rd. Sanford, NC 27338
Property Location (State Road name and Knight 1279
Purpose of Inspection: replace mh
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
of Environmental Health Specialist
Date