ETHTE #: 14 -5 -34391
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Jerme_ Sy ports Phone #: 910 -545 -5591
Address: 59 Ben Ct Bunnlevel NC 28323
Name of Mobile Home Park or S /D: Ben Woods lot 9
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and #): 210 S
Purpose of Inspection: Shed
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
.11 MA Wel 0-1111111 1141111210
AUTHORIZATION OF EXISTING SYSTEM
601 %A
ental Health Specialist
Lo
Date