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HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
NAME 610,a 10, / / l (?/ 6 / I PHONE #,X5 --20& - '2 8'40 9
ADDRESS
NAME OF MOBILE HOME PARK OR S/D S -I -2-4 S 0 n L-4--51
NAME OF OWNER (IF DIFFERENT)
Kenn I--q� , rAC'/'2 4'rtnnin L
ADDRESS OF OWNER (IF DIFFERENT) dl �� C_
PROPERTY LOCATION: STATE ROAD NAME AND # �LP M pa -1 UkJ l7)?-D)?
PURPOSE OF INSPECTION:
The aforementioned site has been evaluated-by-t-h-elTa-r-ne-fl-Co-u-n-ry-H-e-aM Department
Environmental Health Section. At the time of inspection, there appeared to be a septic
system serving this site. If this 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 changes, 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
i� ��.� L4�-yJ v//�//
of Environment Health Specialist �— Date