ETHTE #: 13 -5 -31799
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Michele Temple Phone #: 910 -814 -7748
Address: P.O. Box 2668 Lillington, NC 27546
Name of Mobile Home Park or S /D: Beagle Run lot 7
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and #): Rad Street
Purpose of Inspection: new 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
111201111 W H 113 N32 W411M MAIN 13 M11010
AUTHORIZATION OF EXISTING SYSTEM
M
IZ14,7
of E�ironmental Health Specialist Date