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HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
NAME C~c PHONE # 910 -may/-- 86 L/ 7
ADDRESS loo 28 l~41 kar /2~ „aT' P-.,) FV N C Z~5
NAME OF MOBILE HOME PARK OR S/D /VetEZ/5 (~,o L0 y
NAME OF OWNER (IFDIFFEREN7) -V
ADDRESS OF OWNER (IF DIFFERENT) /83/ cJl~ ~2 C z 7s o
PROPERTY LOCATION: STATE ROAD NAME AND # _2 1'137 4`-,d Of _
PURPOSE OF INSPECTION:
The aforementioned site has been evaluated by the arne oun y ea Department
Environmental Health Section. At the time of inspection, there appeared to be a septic
system serving this site. ff this 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 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
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Date