ETHTE 11-5-26183
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Marsha Thomas Phone 919-499-8879
Address: 2225 Adcock Rd. Lillington, NC 27546
Name of Mobile Home Park or S/D: lot 813
Name of Owner (if different): Jimmy & Michael Thomas
Address of Owner (if different): 929 McAurthur Rd. Broadway, NC 27505
Property Location (State Road name and McNeill
Purpose of Inspection: New Home
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
Siature of Environmental Health Specialist Date