ETHTE 10-5-23888
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Russell Bell Phone
Address: 5170 Marvin Dr Spring Lake, NC 28390
Name of Mobile Home Park or S/D:
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and 2110 Marvin dr
Purpose of Inspection: Bedroom Addition
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 the 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 change, 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
31
Signature
HARNETT q 'Wff HEALTH DEPARTMENT y
p i 8 ti.
ENVIROi, _.,ENTAL HEALTH SECTION N 7
CERTIFICATE OF COMPLETION /OPERATIONAL PERMIT
Name: (owner) AMN4k ew Installation
Property Location: SR# 11 p,, ~,A❑ Repairs
Subdivision Chk 4~~ I ffi Lot #
TAX ID# Quadrant #
Contractor: R-X (AgaA-~ Registration #
Basement with Plumbing: ❑ Garage: ❑
Water Supply: ❑ Well Public ❑ Community
Distance From Well: ft.
Following are the specifications for the sewage disposal system on above captioned property.
Type of system: Conventional ❑ Other
Size of tank: Septic Tank: ICDO gallons Pump Tank: gallons
Subsurface No. of exact length I , width of depth of
Drainage Field ditches of each ditch t OL) ft. ditches ft. ditches Z y in.
French Drain: Linear feet
Date: 2 ,-L-L- 7S
PERMIT NO.
Inspected by::
Environmental Health Specialist
Septic Tank
JNitrification Line