ETHTE 12-5-28800
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEAL
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Shane Gainan Phone 919-499-1701
Address: 48 Apnleton Way Sanford NC 27332
Name of Mobile Home Parr or SID: Laurel Valley
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and NC27
Purpose of Inspection: 20'x30° garage
The aforementioned site has been evaluated by the Harnett County Health Department
Environment 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.
BUILDING LIST E 5' FROM ANY T F SEPTIC SYSTEM
NOT DRIVE OR PARK N SEPTIC SYSTEM
AUTHORIZATION OF EXISTING SYSTEM
Signature of Environmental Hea Specialist