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HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
NAME 00)e A6,,_,i-- PHONE # 011o - 88
ADDRESS /7_ 3 C~% FC?~~25
NAME OF MOBILE HOME PARK OR S/D
NAME OF OWNER (IFDIFFERENI)
ADDRESS OF OWNER (IFDIFFEREN7)
PROPERTY LOCATION: STATE ROAD NAME AND #'~e°'l~i7» 5
PURPOSE OF INSPECTION: b&,k4-, a
The aforementioned site has been evaluated byte Harnett oun y eah Depart ;enf
Environmental Health Section. At the time of inspection, there appeared to be a septic
system serving this site, If this 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 changes, 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
-_7V.-%r
re of Environmental Health Specialist Date