ETHTE 12-5-28183
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Debra Calcutt Phone k
Address: 1084 Claude White Rd Cameron NC 28326
Name of Mobile Home Park or S/D: Beth Wedtke lot 2
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and Claude White rd
Purpose of Inspection: SFD (33'x49)
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 V0111) 11F:
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 LIST E 5' FROM ANY PART OF SEPTIC SYSTEM
NOT DRIVE PARK ON SEPTIC SYSTEM
Signature o Environme
AUTHORIZATION OF EXISTING SYSTEM
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