ETHARNETT COUNTY HEALTH DEPARTMENT
ENVJRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
.,
ADDRESS 318 -
NAME OF MOBILE HOME PARK OR S/D
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
Akk ON ST
AUTHORIZATION OF EXISTING SYSTEM
7
of Environmental Health Specialist Date
WA