ETHTE 1 1-5-2743 5
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Michael & Sabine Collins Phone 919-499-1104
Address: 48 Sweet Gum Circle Sanford NC 27332
Name of Mobile Home Park or S/D: Peachtree Crossing Ph3 lot 95
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and Buffal Lake 1115
Purpose of Inspection: storage shed
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
Lure of E4wfronmental Health Specialist
/f' ~G 11
Date