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ETHTE #: 17-5-40692 HARNETT COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH 307 CORNELIUS HARNETT BOULEVARD LILLINGTON, NC 27546 EXISTING SEPTIC SYSTEM INSPECTION Name: James Newkirk Phone #: 893-2175 Address: 951 Temple Rd Bunnlevel NC 28323 Name of Mobile Home Park or S/D: Name of Owner (if different): Address of Owner (if different): 967 Temple Rd Bunnlevel NC 28323 Property Location (State Road name and #): Temple Rd Purpose of Inspection: Detached Garage (40'x60') 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 2 Signature of Environmental Hbat& Specialist 'Date