ET4.
HTE #: 15-5-36345
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Barbara Wilkerson Phone #: 919-478-4965
Address: 490 Blanchard Rd. Sanford NC 27332
Name of Mobile Home Park or S/D: Coutry Place lot 10
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and #): blanchard
Purpose of Inspection: storage building
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
V,-,. -1, zw 6 t111j---zzC'
gnature of Er�onmental Health Specialist Date