ETX9-5'"
HTE# 21e, .33
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
NAME 2 j ~ ~NUf! PHONE # 9i5 - . 2ge 5577
ADDRESS LI60 fr#,6c_ Grp N s o /
NAME OF MOBILE HOME PARK OR S/D N~ 6eac-1c 4 L,. S/
NAME OF OWNER (IFDIFFERENT) r--C:j,,
ADDRESS OF OWNER (IF DIFFERENT) 1938 _/,Jh~1e,.t,~.r IU . C 2-752V
PROPERTY LOCATION: STATE ROAD NAME AND # 5~e /z/S5
PURPOSE OF INSPECTION:~`e~ J
The aforementioned site has been evaluate y the Harnett Count-y-R-ea-fth Department
Environmental Health Section. At the time of inspection, there appeared to be aseptic
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 Y FROM ANY PART OF SEPTIC SYSTEM
DO NOT DRIVE OR PARK ON SEPTIC SYSTEM
0
AUTHORIZATION OF EXISTING SYSTEM
a
-3-4,,05
of Environmental Health Specialist Date