ET RHTE #: 16-5-39014R
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Govan Sumpter Phone #: 919.996.0023
Address: 170 Sabastian Lane Cameron, NC 28326
Name of Mobile Home Park or S/D:
Name of Owner (if different): Same
Address of Owner (if different): Same
Property Location (State Road name and #): Sabastian Lane (NCSR 1326) / NC 27 W.
Purpose of Inspection: _Replacment of former dwelling with 3 bedroom 24'x52' DWHM Former
dwelling burned down. New DWMH closer to Sabastian Lane and uphill from former. Extisting
septic tank and drainfield not within proposed DWMH placement DWMH already onsite
Renewal of 2016 existing tank inspection
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
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Signature of Environmental Health Specialist Date