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ET RHTE# 07-5 = /;Qap'7i? HARNETT COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH 307 CORNELIUS HARNETT BOULEVARD LILLINGTON, NC 27546 EXISTING SEPTIC SYSTEM INSPECTION NAME /~y,{yg &&,,26a PHONE # }io~?y - e,,76_7 ADDRESS 43(I I+. n,;g, S~~ J!:+b N-C , 7-'N-2-L, NAME OF MOBILE HOME PARK OR S/D Y. 14. L,4-- 100 NAME OF OWNER (IF DIFFERENT) ADDRESS OF OWNER (IF DIFFERENT) PROPERTY LOCATION: STATE ROAD NAME AND # S/L / q14 3 LAEA-29 J ~ 126 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 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 D© NOT DRIVE OR PARK ON SEPTIC SYSTEM AUTHORIZATION OF EXISTING SYSTEM of Environmental Health Specialist Date