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HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
NAME L - B et- fit' c ~\-c l- ti-- PHONE #
ADDRESS 4 1 1 O(- 1 7 ' S--~ ~
NAME OF MOBILE HOME PARK OR S/D C._. 4 41 -
2-NAME OF OWNER (IFDIFFEREN7)
ADDRESS OF OWNER (IFDIFFERENI)
PROPERTY LOCATION: STATE ROAD NAME AND # `/A C a
The aforementioned site has been evaluated by the Harnett County Health. Department
Environmental Health Sectforr At the.time of inspection<Fthere appeared to be a septic' ,
system serving this situ. It thl system should' mall Unctforr, the owner fa responsible ford,
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' FRONt ANY PART OF SEPTIC SYSTEIA
DO NOT DRIVE OIL PARK ON SEPTIC SYSTEM
AUTHORIZATION OF EXISTING SYSTEM
Sig`fta~of En
Date
Health Specialist