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ETHTE #: 15-5-35678 HARNETT COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH 307 CORNELIUS HARNETT BOULEVARD LILLINGTON, NC 27546 EXISTING SEPTIC SYSTEM INSPECTION Name: Victor Kubit Phone #: 322-7755 Address: 17 Clearwater Point Sanford NC 27332 Name of Mobile Home Park or S/D: Radford Heights lot 101 Name of Owner (if different): Address of Owner (if different): Property Location (State Road name and #): 1205 Sheriff Watson Rd Purpose of Inspection: Garage (50'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 1 E I 1ElE,• I, AUTHORIZATION OF EXISTING SYSTEM Signature of Environment"a*#li Specialist ate