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HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
NAME 4, G' C.PHONE # j/9-fb'7- o 388
ADDRESS /86 bCXTc.GCjzIa1 lbie A .C . 2"Z 5 Z 4,
NAME OF MOBILE HOME PARK OR SAD _ i FrL~l old L*~ 6 1
NAME OF OWNER (IF DIFFERENT)
ADDRESS OF OWNER (IF DIFFERENT)
PROPERTY LOCATION: STATE ROAD NAME AND # /yZ~ C.fCi ~c.t~'c
PURPOSE OF INSPECTION: k-fjo
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 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 5' FROM ANY PART OF SEPTIC SYSTEM
DO NOT DRIVE OR PARK ON SEPTIC SYSTEM
of Environmental Health Specialist
AUTHORIZATION OF EXISTING SYSTEM
7-!C. 05
Date