ETHTE #: 15-5-35677
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Mike Tatum Phone #: 910-6902-4197
Address: 900 Gilmore Dr. Sanford, NC 27330
Name of Mobile Home Park or S/D: Buffalo Lakes lot 245
Name of Owner (if different): Samuel & Sandra Wornom
Address of Owner (if different): 1520 Tomberlin Rd Sanford, NC 27330
Property Location (State Road name and #): Mallard
Purpose of Inspection: connect garage to existing tank on property the grage will be built on
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
of Environmenfal Health Specialist Date