ETHTE 11-5-27600
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: John & Peggy Gilbert Phone 808-4238
Address: 21 Pioneer Ct Lillington NC 27546
Name of Mobile Home Park or S/D: Western Harnett Meadows
Name of Owner (if different): Philp Kelly
Address of Owner (if different): PO Box 151 Sanford NC 27331
Property Location (State Road name and 1291 Farrar Rd
Purpose of Inspection: Man Home Placement (28'x70')
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
to
Signatur6 of Environmental Health Specialist