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HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXIST NG SEPTIC SY TEM INSPECTION
NAME PHONE #
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ADDRESS 41Z5'8 G 2,Zd - ~y G Z75 Z(
NAME OF MOBILE HOME PARK OR S/D
NAME OF OWNER (IF DIFFERENT) L .
ADDRESS OF OWNER (IF DIFFERENT)
PROPERTY LOCATION: STATE ROAD NAME AND # SYZ- /V/7 C/174i'r7P/ T6cq
PURPOSE OFINSPECTION, • ;C-~ _ /JO
The aforementioned site has been evaluate byte Harnett County ea Department
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
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 S' FROM ANY FART OF SEPTIC SYSTEM
DO NOT DRIVE OR PARK 014 SEPTIC SYSTEM
AUTHORIZATION OF EXISTING SYSTEM
7-/^dS
of Environmental Health Specialist Date