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t HTE# D - S = 9?5-7 HARNETT COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH 307 CORNELIUS HARNETT BOULEVARD LILLINGTON, NC 27546 EXISTING SEPTIC SYSTEM INSPECTION NAME E . f , A)D/7/aT ' PHONE # 0 - 817 - 7 Z 9 z/ ADDRESS ! z z /fit/( /~x ,4W7-5 N aT75-. ! NAME OF MOBILE HOME PARK OR S/D NAME OF OWNER (IFDIFFEREN7) ADDRESS OF OWNER (IFDIFFEREN7) I PROPERTY LOCATION: STATE ROAD NAME AND # J~(Z 1'5-6 3s 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 septic4 system serving this site. If this 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 MQ-#, BE 5' FROM ANY PART 'OF SEPTIC, SYSTEM D© l DRIVE OR PARK ON SEPTIC SYSTEM AUTHORIZATION OF EXISTING SYSTEM S of Environmental Health Specialist i5. -D Date