ETHTE #: 12 -5 -29802
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Joseph Kihm Phone #: 432 -7101
Address: 558 Oakwater Dr Cameron NC 28326
Name of Mobile Home Park or S /D: Bridlewood Hills lot 6
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and #):
Purpose of Inspection: Storage Building (25'x36')
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 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 change, and/or
4. after six months
.11 M4 Mull 1114 W-13 1914 111190100 01 W 1 EM-313 V owl
AUTHORIZATION OF EXISTING SYSTEM
Signature of En ironmenta He h Specialist
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