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HTE #: 13- 5- 308488
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Jackie Berry Phone #: 863 - 655 -593
Address: 1825 Underwood Terrace
Name of Mobile Home Park or S /D:
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and #): Running Brock
rock
Purpose of Inspection: replace home
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
1 LIJ01-1 0 I 1-1 0 01 .
AUTHORIZATION OF EXISTING SYSTEM
A
of Environmental Health Specialist
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u 12-1
Date