ETHTE# 08-3 O'D _I ~ 18 F
NAME
ADDRESS-~D le-A'(
PHONE #
NAME OF MOBILE HOME PARK OR S/D
NAME OF OWNER (IFDIFFEREN7) S~
ADDRESS OF OWNER (IFDIFFEREN7)
PROPERTY LOCATION: STATE ROAD NAME AND # L'e S \ M
The aforementioned site has been evaluated by the Harnett County Health Department
Environmental Health Section. At the time of inspection, them appeared system serving this site. N this system should malfunction, the owr iresponsible 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 A+fS' BE,
FROM AN PART OF SEPTIC SYSTEM
DO NOT. DRS OR PARK ON SEPTIC SYSTEM
AUT ORIZATION OF EXISTING SYSTEM
Environmental Health Specialist
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Date