ETHTE #: 18-5-44199
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Steve B. McCauley & Tiffany Barefoot Phone #: 910.835.9608
Address: 424 Emerald Lane Broadway, NC 27505
Name of Mobile Home Park or S/D: Boone Trail West 3 PC#D-105A Lot 24
Name of Owner (if different): Debra McCauley
Address of Owner (if different): P.O. Box 947 Broadway, NC 27505
Property Location (State Road name and #): 424 Emerald Ln. (Adcock Rd. SR 1235)
Purpose of Inspection: Replacement SWMH with 3 bedroom DWMH (30'x76'). Extistin¢ Septic
Tank and Drainfield not withingproposed DWMH placement. Sanitary Tee Present. DWMH
shall be placed with addition extending back from foundation of existing SWMH (view diagram)
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 � ftft,vVb
necessary repairs. o,�
TQC,
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
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BUILDING MUST BE 5' FROM ANY PART OF SEPTIC SYSTEM
DO NOT DRIVE OR PARK ON SEPTIC SYSTEM
AUTHORIZATION OF EXISTING SYSTEM
Signature of Environmental Health Specialist Date