ETHTE 1
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Talmette Myers Phone 893-2481
Address: 480 Tom Myers Rd Lillington NC 27546
Name of Mobile Home Park or S/D:
Name of Owner (if different):
BUILDING MUST BE 5'FROM A T SEPTIC SYSTEM
NOT DRIVE OR PARK N SEPTIC ST
AUTHORIZATION OF EXISTING SYSTEM
5
Signature of