ETHTE #: 13 -5 -30788
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Brad Cummings Phone #: 919- 770 -4693
Address: PO Box 145 Sanford NC 27331
Name of Mobile Home Park or S /D:
Name of Owner (if different): Bobby & Karen Powell
Address of Owner (if different): 6405 NC27 Lillington NC 27546
Property Location (State Road name and #): NC27W
Purpose of Inspection: Deck (10'x12')
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
13 LTJ W . W , I 111210 Of W
AUTHORIZATION OF EXISTING SYSTEM
Signature of Environmental, th,Specialist
Date