ETHTE #: 13 -5 -30350
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Kristi Wilkie Phone #: 919- 799 -3776
Address: 1970 Bonlee- Bennett Rd Siler City, NC 27344
Name of Mobile Home Park or S /D:
Name of Owner (if different): Reginald Cox
Address of Owner (if different): P.O. Box 181 Broadway, NC 27505
Property Location (State Road name and #): Rosser Pittman
Purpose of Inspection: Replace Home
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
I ,IP 0
AUTHORIZATION OF EXISTING SYSTEM
'f�: 8 12,,-,, -3
of Environmental ftealth Specialist Date