ETHTE #: 12 -5 -29841
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Victoria Betts Young Phone #: 919 - 499 -6297
Address: 230 Dunrovin Ln Broadway NC 27505
Name of Mobile Home Park or S /D: Dunrovin Est lot 2
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and ft NC27
Purpose of Inspection: Man Home (16'x80'),
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
t1 i 1 1114 LIA M01 ' W111 tH 1 '
AUTHORIZATION OF EXISTING SYSTEM
MW
Signature of Environmental Hft Specialist . Date