ETHTE# 14 5'00 3 99 S
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
NAME �-IthjkS y)) &ntj h l< e PHONE # 3n—'j/!5--5573i9
ADDRESS �lI 'S6.ODc._, L7n. Ako
NAME OF MOBILE HOME PARK OR S/D k- e -NIG r
NAME OF OWNER (IF DIFFERENT) 5e
ADDRESS OF OWNER (IFDIFFERENT)
PROPERTY LOCATION: STATE ROAD NAME AND # 14j1 tk'
PURPOSE OF INSPECTION:
The aforementioned site has been evaluated by the Harnett County Hea—D 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
r AUTHORIZATION OF EXISTING SYSTEM
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of Environmen'flil7flealth Specialist Date