ETHTE #: 13 -5 -31740
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Gary Prillaman Phone #: 893 -2302
Address: 777 Lasater Rd Bunnlevel NC 28323
Name of Mobile Home Park or S /D: Amber Lee lot 2
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and #): 2046 Lasater Rd
Purpose of Inspection: 16'x32' Inground Pool
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 C 1 •' 1'
11 1 1. lull ' A-11 1;
AUTHORIZATION OF EXISTING SYSTEM
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Signature of EnvironmentaTfhth Specialist
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