ETH T E # 4, 2-HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
NAME ~i ld , a- q~
PHONE #9ia-~ .3 -ZdB~
ADDRESS ?a. Soy 535 -7s-y`
NAME OF MOBILE HOME PARK OR S/D
NAME OF OWNER (IF DIFFERENT)
ADDRESS OF OWNER (IF DIFFERENT)
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 ftlspection, 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 V FROM AI4Y PART OF SEPTIC SYSTEM
DO NOT DRIVE OR PARK OIL SEPTIC SYSTEM
AUTHORIZATION OF EXISTING SYSTEM
re of Environmental Health Specialist
r-,-0_.
Date