ETHTE# -5 = 22713
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
NAME bbl~1 G u,~T1" PHONE # 9 0 - ~9a - 6 915
ADDRESS
NAME OF MOBILE HOME PARK OR S/D
NAME OF OWNER (IF DIFFERENT)
ADDRESS OF OWNER (IF DIFFERENT)
PROPERTY LOCATION: STATE ROAD NAME AND # Sj2 1'7o Ch1hW,E1 /2/)
/ftET a~ae-L -{z. ~u~~~ ~ ,~~G ~-cr ~vs; ~F~t ~
PURPOSE OF INSPECTION:
The aforementioned site has been evalu y t e arse oun ea Department
Environmental Health Section. At the time of Inspection, there appeared to be a septic
system serving this site. If this system should malfunction, the owner Is responsible for
any necessary repairs:
Des ~ ems( X/J fTCr ~ / 7%! cr, AIj-- CJ,SS --J
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 changes, and/or
(4) after six months
y~ cvevloP Pzzb#his.e. LBP
BUILDING MUST BE 5' FROM ANY PART OF SEPTIC SYSTEM
DO NOT DRIVE OR PARK ON SEPTIC SYSTEM
AUTHORIZATION OF EXISTING SYSTEM
17 -6 1
of Environmental Health Specialist Date