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HTE# /� =S 3 Zd HARNETT COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH 307 CORNELIUS HARNETT BOULEVARD LILLINGTON, NC 27546 EXISTING SEPTIC SYSTEM INSPECTION NAME�' '.r.r_ `ice ��.PHONE #s .. ADDRESS ,r NAME OF 1 ;ILE HOME PARK 1 NAME OF OWNER (IFDIFFERENT) 6 ADDRESS OF OWNER (IF DIFFERENT) PROPERTY LOCATION: STATE ROAD NAME AND # -%S5`'21 01 PURPOSE OFINSPE CT'ION _ The afor��,en�c�he� �it�h�s �ieert evatust�T y�t� a erne al,n ea nf_. x Deparme �+r iwiiww► .rim :.-...1�!' . ,.�r�. s..r�a`.Y % xa �.' . 3 .. .. r,'�'.. .•.fir �.' . r.. A �.�f'n n aj.. _ . _ _ .�••• ��• •••�� ..�s.� a�av, �t,�wa �xstani anuu�u rnalruflCii©(ft II16'aVilflElf iSresponslb�e f0 ce3 vmm sa�f: �M1 3"t, � t � �ti`.faw r4. .rt r�ecesar �eat�da p r° r 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 BUILDINGMUST BE 51 FROM ANY PART OF SEPTIC'SYSTEM, 1 • • 1 ' • • , •'SEPTIC AUTHORIZATION OF EXISTING SYSTEM of Environmental Health Specialist Date