ETHTE# ~Q - S -Y D,5,~
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
NAME ~/aN,AA4jui , f3~~ PHONE # 2151-840-76.*/
ADDRESS J 15 L A)4zr Fei4s ~)iZ Yelly~ ~
NAME OF MOBILE HOME PARK OR S/D flay,, _ La- S
NAME OF OWNER (IF DIFFERENT)
ADDRESS OF OWNER (IF DIFFERENT)
PROPERTY LOCATION: STATE ROAD NAME AND # /Liy yZ -
PURPOSE OFINSPECTION: 577 tJIL77-i .
The aforementioned site has been evaluated byte arne oun y ea 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
Date
U
of Environmental Health Specialist