ETHTE #: 13 -5 -31054
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Richard Coleman Phone #: 893 -5922
Address: 2155 Wire Rd. Bunnlevel NC 28323
Name of Mobile Home Park or S /D:
Name of Owner (if different): Kathy Powell / Iris Coleman
Address of Owner (if different):
Property Location (State Road name and #): wire rd
Purpose of Inspection: ag rage
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
AUTHORIZATION OF EXISTING SYSTEM
v
of EArifonmental ealth Specialist
Date