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HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
NAME PHONE # Q~I ~ F37 ~ 1 C (
ADDRESS S-6 c tip- A4 C_
NAME OF MOBILE HOME PARK OR S/D 'A-1111-5- crc 1` ,t- 133
NAME OF OWNER (IFDIFFERENT) C ter-
ADDRESS OF OWNER (IF DIFFERENT) 9 CLZ; ~V p7r-v(
PROPERTY LOCATION: STATE ROAD NAME AND #
The aforementloned site has been evaluated by the Harnett. County Health Department:
Environmental Health Section. At tide time of inspection, there appeared to bey a septid j
system serving thid site. If thin syster» should malfunction the owner Is responsible for;
any necessary repah~ r i
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 ANY PART O SEPTIC SYSTEM
DES NOT DRIVE OR PARK ON SEPTIC :SYSTEM
AUTHORIZATION OF EXISTING SYSTEM
of Environmental Health Specialist Date