ETHTE 12-5-28901
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Duane Griffin Phone 919-353-2164
Address: 56 Byrd Griffin Ln Broadway NC 27505
Name of Mobile Home Park or SID:
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and B3Td Griffin Ln
Purpose of Inspection: Mod Replacement
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 ]EF:
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 E' FROM A PART P SEPTIC SYSTEM
NOT DRIVE A ON SEPTIC SYSTEM
ATION OF EXISTING SYSTEM
a
Signature of