ETHTE #: 18-5-43525
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Ouality One Contractiin Phone #: 919.909.3495
Address: P.O. Box 1444 Cary, NC 27512
Name of Mobile Home Park or S/D: NA
Name of Owner (if different): David Walker
Address of Owner (if different): 492 Rollins Mill Road Holly Springs NC 27540
Property Location (State Road name and #): 492 Rollins Mill Road (SR 1401)
Purpose of Inspection: Accessory Detached Garage Storage Building (24'x40')No bathroom
No bedrooms. Proposed building not within septic field repair area or septic setbacks
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
03 / �I I
Signature of Environmental Health Specialist IrDate