ETHTE 12-5-28790
HAy[ NETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS IIARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Autumn Hammer Phone 919-499-5142
Address: 553 Omaha Dr Braodway NC 27505
Name of Mobile Home Park or S/D: Tingen Pointe
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and NC27
Purpose of Inspection: 26'x11' 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 SPECTION S VOID
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 UST 5' FROM ANY PART OF SEPTIC SYSTEM
NOT DRIVE N SEPTIC SYSTEM
AUTHORIZATION OF EXISTING SYSTEM
U-W
Signature of Environmental He %k