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HTE# HARNETT COUNTY HEALTH DEPARTMENT ENVJRONMENTAL HEALTH 307 CORNELIUS HARNETT BOULEVARD LILLINGTON, NC 27546 EXISTING SEPTIC SYSTEM INSPECTION NAME f{tiy, /'` PHONE # fir' ADDRESS A). -Z NAME OF MOBILE HOME PARK ORS /D�,y�� NAME OF OWNER (IF DIFFERENT) ADDRESS OF OWNER (IF DIFFERENT) PROPERTY LOCATION: STATE ROAD NAME AND # q C0 g12,45 i-' r PURPOSE,© IN,PEGTION• ''z@'��i�i3',�,i', i`'"�' "� ti 4T i�qv i ^: c t` Th afar_menti s er��±�rr��uaf`q# � au ea e��rtmenl D rlir�nme t cf one �h1 {n f =e�l�I�ared a try RIX x..a,, p# system �e�vin� f � �si�� tti��s sys�er sfio�u�t�ialfur�c #'�o�, ��ie owner is r�s��nsib�� for,�G 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 Siture of Environmental Health Specialist Date