ETHTE #: 17-5-42992
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Robert Wright Phone #: 919-842-6770
Address: 3014 Cool Springs Rd Broadway NC
Name of Mobile Home Park or S/D: Stoney Creek Manor
Name of Owner (if different): Stella Dickerson
Address of Owner (if different): 219 Glenn Oak Dr Broadway NC 27332
Property Location (State Road name and #): Glen Oak Dr
Purpose of Inspection: Concrete Patio (10'x20')
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
119
Signature of Environmental