ETHTE 11-5-26562;26561
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Johnson, Tim Robin Phone
Address: 613 S Main St Broadway Nc 27505
Name of Mobile Home Park or S/D: Archie Cameron Estates Lot 4
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and 1280 McArthur Rd
Purpose of Inspection: 30'x40' Detached Garage 2 Attached Porches
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`I 5' IPROA ANY PART OF SEPTIC SYSTEM
DO NOT D IVE OR VA IRK ON SEPTIC SYSTEM
AUTHORIZATION OF EXISTING SYSTEM
Signaturb of Environmental Hea'"ecialist