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HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
NAME PHONE # ADDRESS 2T Lc I Z~7 CT C Z -7!S`o
NAME OF MOBILE HOME PARK OR S/D
NAME OF OWNER (IF DIFFERENT)
ADDRESS OF OWNER (IF DIFFERENT)
PROPERTY LOCATION: STATE ROAD NAME AND # / s'38
PURPOSE OF INSPECTION: -S ,v,- 14 S~ /,,t)J Zx z r, ~
The aforementioned site has been evaluated by the Harnett County Heaith Department
Environmental Health Section: At the time of inspection, there appeared to be a septfd
system serving this site. tf this system should malfunction; the owner is responsible for-I.,
any necessary repair**::
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 T FROM ANY PART OF SEPTIC SYSTEM
DO NOT DRIVE OIL PARK ON SEPTIC SYSTEM-
AUTHORIZATION OF EXISTING SYSTEM
- , C-- i r,~,, L,97f 4 Z -G-
of Environmental Health Specialist Date