ET RRHTE 08-5-20898RR
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: James & Marv Mason Phone 551-8231
Address: 1904 BrookcliffRd Sanford NC 27330
Name of Mobile Home Park or S/D: AB Bethune
IS INSPECTION IS VO 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 UST E 5' FROM ANY PART SEPTIC SYSTEM
NOT DRIVE A N SEPTIC SYSTEM
AUTHORIZATION OF EXISTING SYSTEM
Signature of