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ETHTE# Q - 2f f 3 2. HARNETT COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH 307 CORNELIUS HARNETT BOULEVARD LILLINGTON, NC 27546 EXIS'T'ING SEP'T'IC SYSTEM INSPECTION NAME PHONE # W -135S ADDRESSES- C NAME OF MOBILE HOME PARK OR S/D NAME OF OWNER (IFDIFFERENI) l~~+-L ( -FS ADDRESS OF OWNER (IFDIFFEREN7) 4:bc I3~s>~s6w 12--6 4t, /Q, ('7-?s-e) PROPERTY LOCATION: STATE ROAD NAME AND #2 (2-b PURPOSE. OF INSPECTION: The aforementioned site has been evaluated bytheHaarne oun y ea Department ; 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 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 BUILDING MUST BE 5r FROM_ANY'PARTQFSEPTIC SYSTEM. DO'NOT DRIVE ®R PARK QN SEPTIG SYSTEM:. . AUTHORIZATION OF EXISTING SYSTEM -Z - r z- ature of Environmental Health Specialist Date