ETHTE 12-5-28798
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Mitchell Barger Phone 910-497-2365
Address: 5085 Marvin Ln Sorin%t Lake NC 28390
Name of Mobile Home Park or S/D:
Name of Owner (if different):
THIS INSPECTION 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 LIST E 5'FROM A PART SEPTIC SYSTEM
NOT DRIVE OR PARK N SEPTIC SYSTEM
AUTHORIZATION OF EXISTING SYSTEM
Signature
31)1.
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