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HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
NAME ~~,°f EF,6U_T_ PHONE #
ADDRESS 3(~ 2-252--/6-
NAME OF MOBILE HOME PARK OR S/D L 7'
NAME OF OWNER (IFDIFFF.RF.V7)
ADDRESS OF OWNER (IF DIFFERENT)
PROPERTY LOCATION: STATE ROAD NAME AND # 7F5_-7 _j y 3i- tzv7)
PURPOSE OF INSPECTIO'V
The aforementioned site has been evaluated by t e arnetountHeafth Departmen
Environmental Health Section. At the time of inspection, there appeared to be a septic
system serving this site. If this system should malfunction,' the owner Is responsible for a
any necessary repairs;_
THIS INSPECTION IS VOID IF:
(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 changes, and/or
(4) after six months
NY PART OF SEPTIC SYSTEM
BUILDING MUST BE5 FROM
00 NOT DRIVE OR PARIS ON'SEPTIG SYSTEMa
AUTHORIZATION OF EXISTING SYSTEM
z 5--/
re of Environmental Health Specialist
Date