ETHTE# I& 600 361
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
n n EXISTING SEPTIC SYSTEM INSPECTION
NAME !L/) K�ti�� &VA P1 PHONE #
ADDRESS
NAME OF MOBILE HOME PARK OR S/D h4 Bu s &sy tzw 1—d M OF OWNER (IF DIFFERENT) k A k J YL� &
ADDRESS OF OWNER (IF DIFFERENT)
PROPERTY LOCATION: STATE ROAD NAME AND # ,�f2
PURPOSE OF INSPECTION:
The aforementioned site has been evaluated by the a—r—n—effZ6`un1yffea—n 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 T FROM ANY PART OF SEPTIC SYSTEM
DO NOT DRIVE OR PARK ON SEPTIC SYSTEM
AUTHORIZATION OF EXISTING SYSTEM
of Environmekaf Health Specialist Date