ETHTE #: 14 -5 -34108
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Cumberland Homes Phone #: 892 -4345
Address: PO Box 727 Dunn NC 28335
Name of Mobile Home Park or S /D: Woodshire lot 1
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and #): Nursery Rd
Purpose of Inspection: SFD (50'x40')
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
1 1 . I ZEN IN I
AUTHORIZATION OF EXISTING SYSTEM
Signature of Environmental Healthecialist b ate