ETHTE# 2I L- Z- HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
NAME
I -J
ADDRESS 5
cl! /4-)
/L~ C 2-715-1
NAME OF MOBILE HOME PARK OR S/D Lee, f j -7
NAME OF OWNER (IFDIFFERENT)
ADDRESS OF OWNER (IF DIFFERENT) /U_C' 774
PROPERTY LOCATION: STATE ROAD NAME AND #(5,,Q,//,/ PURPOSE OF INSPECTION rrt~, ~ ' %-fi
The aforementioned site has been ev auated ~y t'e Fwarnetttoun ea7th De artmenf
p
Environmental Health Section. At the time of inspection, there appeared to be aseptic
system serving this site. If this system should malfunction, the owner is responsible for-ao
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a any_pecessary 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 changes, and/or
(4) after six months
BUILDING MUST EE5' FROM, ANY'PART~OF SEPTIC SYSTEM,,
NOT, DRIVE, 'OR PARK ON 'SEPTIC SYS'EM
S
re of Environs
AUTHORIZATION OF EXISTING SYSTEM
Health Specialist
/0-7-//
PHONE # ? ~Z Z - o z~
Date