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ETHTE #: 15-5-37744 HARNETT COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH 307 CORNELIUS HARNETT BOULEVARD LILLINGTON, NC 27546 EXISTING SEPTIC SYSTEM INSPECTION Name: Tommy Binkley Phone #: 919-935-3998 Address: 83 McNeil Mill Rd Broadway NC 27505 Name of Mobile Home Park or S/D: Name of Owner (if different): Address of Owner (if different): Property Location (State Road name and #): McNeil Mill Rd Purpose of Inspection: Man Home (30'x56') 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 BUILDING MUST BE 5' FROM ANY PART OF SEPTIC SYSTEM DO NOT DRIVE OR PARK ON SEPTIC SYSTEM AUTHORIZATION OF EXISTING SYSTEM Signature of Environmental TWtb Specialist Date