ETHTE 10-5-25125
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMEN'T'AL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Nichols Building, Inc Phone 551-9830
Address: 1010 Cedar Creek Rd Fayetteville, NC 23312
Name of Mobile Home Park or S/D:
Name of Owner (if different): Charles Gilchrist
Address of Owner (if different): 406 Brower Rd Cameron NC 2832
Property Location (State Road name and Brower Rd 1157
Purpose of Inspection: Porch Addition
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
114-`,`,,~) '1) 1 U
Signature of nvironmental Health Sp ialist a e