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HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
NAME u K (?j'15T4(Ck- P ONE V)l - 7~n(r
ADDRESS 6 vj- L9 } r( C~ 3
NAME OF MOBILE HOME PARK OR S/D
NAME OF OWNER (IFDIFFERENT) ~.J f
ADDRESS OF OWNER (IFDIFFEREN7)
PROPERTY LOCATION: STATE ROAD NAME AND #
The aforementioned site has been evaluated by the Harnett County Health Department
Environmental Health Section. At the time of lnspection, thers appeared to beg septicI:
system serving thid situ If this system should"malfunctf6r~ tie owner is responslhle fad
any necessary repairs. .
n
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
Da NOT DRIVE OR PARIS ON SEPTIC SYSTEM
AUTHORIZATION OF EXISTING SYSTEM
Signature of Environmental fIealt Specialist