ETHTE #: 17-5-42204
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Charles & Sharon James Phone #: 919-669-1264
Address: 2092 Bailey Rd. Coats, NC 27521
Name of Mobile Home Park or SID: NA
Name of Owner (if different): Same
Address of Owner (if different): Same
Property Location (State Road name and #): 2092 Bailey Rd. (SR 1561)
Purpose of Inspection: Unattached Accessory Barn (20'x20') with Bathroom - Bathroom
plumbed withrg avity fall to existing septic system at SFD. Cleanout pipes recommined.
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
� �� Oct l i9
Signature of Environmental Health Specialist Date
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