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ETHTE# O7_5 = jgyg HARNETT COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH 307 CORNELIUS HARNETT BOULEVARD LILLINGTON, NC 27546 EXISTING SEPTIC SYSTEM INSPECTION NAME PHONE # ~'/y- 3~/ - 4Gt93 ADDRESS J7e C • 7-75-0/ NAME OF MOBILE HOME PARK OR S/D / NAME OF OWNER (IFDIFFEREN7) ADDRESS OF OWNER (IF DIFFERENT) PROPERTY LOCATION: STATE ROAD NAME AND # -<vg IW6 T,dr•-~„/a ~ 149 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 AUTHORIZATION OF EXISTING SYSTEM 0 of Environmental Health Specialist Date