ETHTE 11-5-26733
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LI LINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Impact Home Solutions Phone 919-422-8330
Address: 5528 Cahaba Waugh NC 27616
Name of Mobile Home Park or S/D: Forest Oaks lot 140
Name of Owner (if different): Yernan & Jill Christman
Address of Owner (if different): 20 Bluebonnet Oak St Bunnlevel NC 28323
Property Location (State Road name and 1125 Lemuel Black Rd
Purpose of Inspection: Covered Patio & Deck Addition
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
Signature of
AUTHORIZATION OF EXISTING SYSTEM
5
Specialist