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ETHTE #: 16-5-37844 HARNETT COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH 307 CORNELIUS HARNETT BOULEVARD LILLINGTON, NC 27546 EXISTING SEPTIC SYSTEM INSPECTION Name: Porch Conversion Phone #: 777-3363 Address: 6821 Market St Wilmington NC 28405 Name of Mobile Home Park or S/D: Trotters Ridge Name of Owner (if different): Kelvin Snow Address of Owner (if different): 66 Kentucky Derby Ln Lillington NC 27546 Property Location (State Road name and #): Docs Rd Purpose of Inspection: Screened Room (12'x12') 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 qo-N5 a 1-i1 I ., Signature