ETHTE #: 15-5-37411
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Hamilton Builders Inc Phone #: 890-0973
Address: 286 Ana St East Ellington NC 27546
Name of Mobile Home Park or S/D: Manor Hills lot 2
Name of Owner (if different): Kate Siletzkv
Address of Owner (if different): 67 Dees St Lillington NC 27546
Property Location (State Road name and #): Dee St
Purpose of Inspection: Screen Porch (12'x16')
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
BUILDING MUST BE 5' FROM ANY PART OF SEPTIC SYSTEM
DO NOT DRIVE OR PARK ON SEPTIC SYSTEM
AUTHORIZATION OF EXISTING SYSTEM
1Z
Signature of Environmental Hei Specialist