ETHTE 11-5-26401 & 11-5-26402
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Yesenia Pinales Phone 919-247-4681
Address: 1613 Maybrook Dr. Raleigh, NC 27610
Name of Mobile Home Park or S/D:
Name of Owner (if different): Kimberly Castillo
Address of Owner (if different): 260 Hollie Pines Rd. Broadway, NC 27505
Property Location (State Road name and Serenity Lane
Purpose of Inspection: Deck & Storage Building
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
gnature of Environmental Health Specialist
Date