ETHTE #: 14 -5 -33784
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Rachael Buchanan Phone #:
Address: 135 Faircloth Ln Broadway NC 27505
Name of Mobile Home Park or S /D:
Name of Owner (if different): Andrea Faircloth
Address of Owner (if different): 224 Beuce Dr Broadway NC 27505
Property Location (State Road name and #): Hillman Grove Rd
Purpose of Inspection: Man Home (14'x70')
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
AUTHORIZATION OF EXISTING SYSTEM
NNE
Signature of Ertvironmeii f�Mealth Specialist