ETHTE 11-5-27721
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Adam Swann Phone 498-5809
Address: 216 Buie Rd Broadway NC 27505
Name of Mobile Home Park or S/D:
Name of Owner (if different): Calvin Swann
Address of Owner (if different): 384 Buie Rd Broadway NC 27505
Property Location (State Road name and 1213 Buie Rd
Purpose of Inspection: Man Home 31'x56'
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.
BUILDING UST 5' FROM A T SEPTIC SYSTEM
NOT DRIVE OR PARK N SEPTIC SYSTEM
AUTHORIZATION OF EXISTING SYSTEM
Signature of Environmental