ETHTE #: 13 -5 -32643
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Richard Drake Phone #: 608 - 630 -6614
Address: 63 Stoney Creek Dr Sanford NC 27332
Name of Mobile Home Park or S /D: Stoney Creek Manor lot 1
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and #): NC27
Purpose of Inspection: Out Building _(28'x40')
The aforementioned site has been evaluated by the Harnett County Health Department
Environmental Health Section. At the time ®f 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
11 1 10011914 A. 1114 krI9111W] m
AUTHORIZATION OF EXISTING SYSTEM
Signature of"Environmen%abHealth Specialist