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ETHTE# /Ir HARNETT COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH 307 CORNELIUS HARNETT BOULEVARD LILLINGTON, NC 27546 EXISTING SEPTIC SYSTEM INSPECTION NAME Wk1ko,_. 116-d-a//e, 13,946<- PHONE # aj -:;,-5-2- I W7 S7V6 1 !s Zf- Cllacce N.C. NAME OF MOBILE HOME PARK OR S/D NAME OF OWNER (IFDIFFEREN7) ADDRESS OF OWNER (IFDIFFEREN7) PROPERTY LOCATION: STATE ROAD NAME AND # . /yes Izi--ls Cht*ee~ /lo PURPOSE OF INSPECTION: The aforementioned site has been evaluated by the acne oun R-e-aftb 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 1 L/ Data