ET
HTE# 06
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM (INSPECTION 7
NAME j L. , 1L-,~ D 1 1LC~t PHONE N ADDRESS
NAME OF MOBILE HOME PARK OR S/DVe
NAME OF OWNER (IFDIFFEREN7) Ss~`7
ADDRESS OF OWNER (IFDIFFEREN7) $c~
PROPERTY LOCATION: STATE ROAD NAME AND # AYZ
S The aforementioned site has been evaluated by the Harnett County Health Department
f Environmental Health Section. At the time of inspection, there appeared to be a septic
system serving this site. If this system should malfunction, the owner is responsible for
necessary repairs. s
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
1
BUILDING MUST BE 5' FROM ANY PART OF SEPTIC SYSTEM
DO NOT DRIVE OR PARK ON SEPTIC SYSTEM
AUTHORIZATION OF EXISTING SYSTEM
&atur ctor Date