ETHTE# D7-- /909
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
NAME -,L~,& 12 j4,t7- PHONE #.,2e -0'7- qZ 72
ADDRESS ~3S 2Q (-d)qL~ /d, C 2 S a 1
NAME OF MOBILE HOME PARK OR S/D
NAME OF OWNER (IF DIFFERENT)
ADDRESS OF OWNER (IF DIFFERENT)
PROPERTY LOCATION: STATE ROAD NAME AND # -.-W Zvo4, C;9~4P 10A
The aforementioned site has been evaluated by the Harnett County. Health Department; ~ j
Environmental Health Section. At the. Urnt of lnspecttor% there appeared fo be a septic= J,
system serving, this situ If this system should' malfunctoor% the owner is responsible tore
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 T FROM ANY PART OF SEPTIC SYSTEI14
DO NOT DRIVE OR PARK ON SEPTIC SYSTEM
AUTHORIZATION OF EXISTING SYSTEM
49 /C5.
;nature of Environmental Health Specialist
- C~ -d
Date