ET RHTE #: 14- 5- 33193R
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Justin Diebold Phone #: 919 - 359 -2440
Address: 125 Anna Dr. Clayton NC 27520
Name of Mobile Home Park or S /D: Woodshire lot 192
Name of Owner (if different): Chris Munsell
Address of Owner (if different): 160 Kimbrough Dr. Lillington NC 27546
Property Location (State Road name and #): 160 Kimbrough Dr
Purpose of Inspection: Pool (18'x36')
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 OIL, '•' ' 0l � I �•
AUTHORIZATION OF EXISTING SYSTEM
WME
Signature nvironmental H h Specialist