ETHTE #: 13 -5 -30779
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: David Lind Phone #: 919- 777 -4610
Address: PO Box 994 Sanford NC 27331
Name of Mobile Home Park or S /D: Buffalo Lake
Name of Owner (if different): Norman & Patricia Keith
Address of Owner (if different): 2212 Lord Ashley Dr Sanford NC 27331
Property Location (State Road name and #): Vick Keith Rd
Purpose of Inspection: Carport
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
111101110 1' f W, . H
AUTHORIZATION OF EXISTING SYSTEM
Signature of
Health Specialist