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HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
NAME ~/l. Je ~S 2y PHONE # 9/q-s-S-7 -S 6
ADDRESS 19 y r v. N c. ,-:2
NAME OF MOBILE HOME PARK OR S/D Lr,~oQ,4I~aL Z
NAME OF OWNER (IF DIFFERENT)
ADDRESS OF OWNER (IF DIFFERENT) S.vT.. .
PROPERTY LOCATION: STATE ROAD NAME AND # 5,2 1512 y Q-A L-ia~. tZD
PURPOSE OF INSPECTION: C CK mr
The aforementioned site has been bvaluated by the Harnett County Heaith 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
AUTHORIZATION OF EXISTING SYSTEM
vironmental Health Specialist
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Date