ETHTE #: 14 -5 -33422
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Rising Sun Pools Phone #: 919 -851 -9700
Address: 5608 Hillsborough St Raleigh NC 27606
Name of Mobile Home Park or S /D: Tirzah Village
Name of Owner (if different): Nancy Birchard
Address of Owner (if different): 16 Atkins Ferry Rd Lillington NC 27546
Property Location (State Road name and #): US421
Purpose of Inspection: In Ground Pool (15'x34')
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
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AUTHORIZATION OF EXISTING SYSTEM
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Signature of Environmental`I41th Specialist