ETHTE #: 14 -5 -33493
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: James West Phone #: 814 -7320
Address: 3261 Hwy401 Lillington NC 27546
Name of Mobile Home Park or S /D: Carl Womble lot 2
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and #):
Purpose of Inspection: Sunroom (16'x22')
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
i 1
1 ' '•
13 MA W11
AUTHORIZATION OF EXISTING SYSTEM
Signature of Environmental He Specialist ate