ETHTE k 09-5-23515
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Jason Betts
Phone 514-8098
Address: 5035 NC 210 Bunnlevel NC 28323
Name of Mobile Home Park or S/D:
Name of Owner (if different): Jimmy Autry
Address of Owner (if different): 5845 NC210 Bunnlevel NC 28323
Property Location (State Road name and NC210S
Purpose of Inspection: House Addition
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
BUILDING MUST BE 5' FROM ANY PART OF SEPTIC SYSTEM
DO NOT DRIVE OR PARK ON SEPTIC SYSTEM
UTHORIZATION OF EXISTING SYSTEM
Signature of Environmental Healt ecialist D,