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ET RRHTE# d 5- HARNETT COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH 307 CORNELIUS HARNETT BOULEVARD LILLINGTON, NC 27546 EXISTING SEPTIC SYSTEM INSPECTION NAME CN Noce Gi X44 ~\o Nti 3 PHONE # ~ N-773 ` ADDRESS QL.ro VF'N~ L,4,LLE ~$3O3 NAME OF MOBILE HOME PARK OR S/D V©x NAME OF OWNER (IF DIFFERENT) VQ, tjg-.o v\ ADDRESS OF OWNER (IF DIFFERENT) PROPERTY LOCATION: STATE ROAD NAME AND # a v N l ~-1 The aforementioned site has been evaluated by the Harnett County Health Department J. Environmental Health Section. At the time of inspection, there appeared to be a septic. system serving this site. If thls 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 changes, and/or (4) after six months BUILDING MUST BE 5' FROM ANY PART OF SEPTIC SYSTEM DO NOT DRIVE OR PARK ON SEPTIC SYSTEM AUTHORIZATION OF EXISTING SYSTEM Signature of Environmental Health ecialict