ETHTE 11-5-27539
HAEZNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LIILINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Lawrence Curtis Phone 919-708-2316
Address: PO Box 1133 Broadway NC 27505
Name of Mobile Home Park or S/D: Bailey D Hall
Name of Owner (if different): Charles Brown
Address of Owner (if different): 1212 Claude White Rd Sanford NC 27330
Property Location (State Road name and 1001 Claude White Rd
Purpose of Inspection: 20'x20' Detached Garage
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
Signature of Environmentalalth Specialist