ETHTE# ZL E: 2
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
NAME OF OWNER (IFDIFFERENI)
ADDRESS OF OWNER (IFDIFFEREN7)
PROPERTY LOCATION: STATE ROAD NAME AND #
PURPOSE OF INSPECTION;
The aforementioned site has been evaluat ~ t e erne gun ea Department
Environmental Health Sectfw.~ At the time of lnspectl rtt there appeared to be a septic ~
system serving thfit situ If this system should rnalfunotioM the owner Is responsible for
any necessary repalre ' s
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 5' FROM ANY PART OF SEPTIC SYSTEM
D NOT DRIVE O PARK OIL SEPTIC SYSTEM.
AUTHORIZATION OF EXISTING SYSTEM
17q 36
of Environmental Health Specialist
Date