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HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
NAME 06405 PHONE # 9/9 - 557- 735
ADDRESS 60 1?-V7-1-1 #a f- I/ N c z ~s Z~
NAME OF MOBILE HOME PARK OR S/DI( W nags
NAME OF OWNER (IF DIFFERENT)
ADDRESS OF OWNER (IFDIFFERENI)
PROPERTY LOCATION: STATE ROAD NAME AND # ,$,L iY37 W4tn4 (Jadc(S
,A) C)
PURPOSE OF INSPECTION: .12 X.2O .S7 -
The
The aforementioned site has been evaluat byte arne oun y ea 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.
cm- SI.c &-G- {'-0 2 /q<C c S5
THIS INSPECTION IS VOID IF: +o 1-714,r,
(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 5' FROM ANY PART OF SEPTIC SYSTEM
DO NOT DRIVE OR PARK ON SEPTIC SYSTEM
AUTHORIZATION OF EXISTING SYSTEM
of Environmental Health Specialist Date
HARNETT COUNTY HEALTH DEPARTMENT
HTE C)i+-5-10294 ENVIRONMENTAL HEALTH SECTION 1 6 7 1 2
OPERATIONS PERMIT
Name: (owner) New Installation Septic Tank
Property Location: SR# lr-t Repairs
~ Nitrification Line
Subdivision, ~P,u a~oo Lot # _ 5~
Tax ID #
Contractor: T r,Nv1%j o ~
Basement with Plumbing: L~ Garage:
Quadrant #
Registration #
Water Supply: 71 Well Public [71 Community
Distance From Well: 50 ft.
Following are the specifications for the sewage disposal system on above captioned property.
Type of system: 'A Conventional I Other
Size of tank: Septic Tank: tooo gallons Pump Tank gallons
Subsurface. No. of exact length width of depth of
Drainage Field ditches of each ditch vod ft. ditches 3 ft. ditches a4
_in.
French Drain Required: Linear feet
PERMIT NO. a~
16` ac4e5S lane, all oweJ
arâ–º 14+ SJe 4 d V-Am
t i 1AcS r;v i v~ -11r.
~ u; I c~rNe
611 cCti~YI'~YICS.
Date: I
Inspected by: t
Enviromnental Healt ecialist
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