ET RHTE #: 15-5-36891R
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Jonathan Pope Phone #:
Address: 528 Johnson Rd. Coats, NC 25721
Name of Mobile Home Park or S/D:
Name of Owner (if different): Bobby Pope
Address of Owner (if different): 19 Silas Moore Rd. Coats, NC 27521
Property Location (State Road name and #): Dixon Rd. (SR 1559)
Purpose of Inspection: Replace SWMH - SWMH shall not be within 5ft of exisitng septic tank
and field. No driving or parkin in n septic area. Have tank pumped on a routine basis for system
maintance.
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 Health Specialist Date