ETHTE# a9- S = Z1775-
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
NAME C9er1kC PHONE # 71S - 5's7 - c,/:z y
ADDRESS S-2,5- f?_*s F' v N c
NAME OF MOBILE HOME PARK OR S/D C d,s N ( 3
NAME OF OWNER (IF DIFFERENT)
ADDRESS OF OWNER (IF DIFFERENT)
PROPERTY LOCATION: STATE ROAD NAME AND # 5,7 Yt a / r
PURPOSE OF INSPECTION: AVW- ~ AZ~-j
The aforementioned site has been evafuatod by the Harnett Counter Health Department
Environmental Health Section: At the time of Inspectforr« there appeared to be a septic.
system serving this site. If this system should malfiit ctiom. the owner is responsible ford`
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 V FROM ANY PART OF SEPTIC SYSTEM.
DO NOT DRIVE OIL PARK ON SEPTIC SYSTEM
AUTHORIZATION OF EXISTING SYSTEM
of Environmental Health Specialist
-3-z,5--6
Date