ETHTE 11-5-27007
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Pleasant Hill Advent Christian Church Phone 910-308-3132
Address: 2061 Raynor McLamb Rd. Bunnlevel, NC 28356
Name of Mobile Home Park or S/D:
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and Raynor McLamb
Purpose of Inspection: foyer/bathroom 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
AUTHORIZATION OF EXISTING SYSTEM
'7
1'r (z i:
Date
Signature of Environmental Health Specialist