ETHTE# 300 t106&1S
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
NAME jour -)j' J"jr-e PHONE # 511-1261-a'1'13
ADDRESS ✓-Ln r��//� <r%�py� 17s tel/_
NAME OF MOBILE HOME PARK OR S/D A ����f` �ai"�
NAME OF OWNER (IF DIFFERENT)
ADDRESS OF OWNER (IFDIFFERENT) S
PROPERTY LOCATION: STATE ROAD NAME AND #
50e.1-�. &- C& /2,oQl
PURPOSE OF INSPECTION. /— / v-
The aforementioned site has been evaluated by the Harnett Cio-u—nfy-HeufthDepartment
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
U
of Environmehtail Health Specialist