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HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
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NAME f ~t ! V y f! ~4 I PHONE # 0 10 - 3.)q -
ADDRESS ~ aj Si. pr-1 sy a~ (1 C--
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NAME OF MOBILE HOME PARK OR S/D
NAME OF OWNER (IFDIFFERENT)
ADDRESS OF OWNER (IF DIFFERENT)
PROPERTY LOCATION: STATE ROAD NAME AND # L a--?
PURPOSE OF INSPECTION:
The aforementioned site has been evaluated byte rneft-C-ou-ffy-Wea-fth ar 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 DUST BE S! FROM ANY PART OF SEPTIC SYSTEIW }
DO NOT DRIVE OIL PARK OIL SEPTIC SYSTEM
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AUTHORIZATION OF EXISTING SYSTEM
Environmental Health Specialist
Date