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ETHTE# Z 7t,,&5 HARNETT COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH 307 CORNELIUS HARNETT BOULEVARD LILLINGTON, NC 27546 EXISTING SEPTIC SYSTEM INSPECTION NAME i~ ~ PHONE # 5/7 Z Y 20 ADDRESS 7 /,A: zzZ 4, A - ~ Z zS-y Z NAME OF MOBILE HOME PARK OR S/D NAME OF OWNER (IFDIFFERENT) 141- i~ ADDRESS OF OWNER (IF DIFFERENT) 8? - Ca~ Si Ste; )C0 C~-Y~ /~`C 7_5, PROPERTY LOCATION: STATE ROAD NAME AND # / p SCE PURPOSE. -OF IAISPECTIONf The aforementioned site_ as been evaluated ~y th~ e i40 6-616 01th ©epartment Environmental Health.Section: Atthe time:of"irispection,- there, appeared to be a septic system serving this-site: IfA is,system should malfunction, thb owner. Is responsible for {s }necesary repair any r° s m r '~R v,, •s S p lz,k~ J 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 ~='p•.,tc.'~. <ro~.Cf~t rc ar.-".,'.zr r _h..o.n~.~_~.,n-'.:;' - w, •'y z.'.,FS x~.,-u-ice ~ ~.q ~F i -,qi ';.~d BUILDING MUST BE 5' FROM ANY PARS OF SEPTIC SYSTEM ti 4 DO` NOT DRIVE OR PARIS ON SEPTIO, SYSTEM ;E AUTHORIZATION OF EXISTING SYSTEM of Environmental Health bate