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HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXIS'T'ING SEP'T'IC SYSTEM INSPECTION
NAINIE ,l6-5f --~c-ke z- PHONE # 730 - 0 75
ADDRESS A) . 5 ~
NAME OF MOBILE HOME PARK OR S/D 7~~
NAME OF OWNER (IF DIFFERENT)
ADDRESS OF OWNER (IF DIFFERENT)
PROPERTY LOCATION: STATE ROAD NAME AND 5tlgy0 Al~rwkS Ii>
)Q 5 Eczf~W
PURPOSE OF INSPECTION: I),C % fns. r- t ~n
The aforementioned site has been eval
u
ment
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
/ _ ~I- IT, - /:-7-e '
attire of Environmental Health Specialist
-2-/ 0
Date
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