ETHTE #: 15-5-35618
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: David Knapp Phone #: 985-0487
Address: 33 Tweets Ln Bunnlevelo NC 28323
Name of Mobile Home Park or S/D: Anderson Creek School Rd lot 2
Name of Owner (if different): Everrette Coats
Address of Owner (if different): 2653 Hope Mills Rd Ste 7 Fayetteville NC 28306
Property Location (State Road name and #): 405 Anderson Creek School Rd
Purpose of Inspection: Man Home Placement (28'x60')
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
lH 1 WAIR 1024111109-63
AUTHORIZATION OF EXISTING SYSTEM
3
Signature of EnvirXm"e*l Health Specialist r J Date