ETHTE 12-5-28678
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Jim Rhodes Phone 919-868-6703
Address: 856 B Olivers Grove Rd Four Oaks NC 27574
Name of Mobile Home Park or S/D: Mamie Bell Ridge
Name of Owner (if different): Melody Esteo
Address of Owner (if different): 91 Mamie Ferguson Dr Lillingion NC 27546
Property Location (State Road name and Old US421
Purpose of Inspection: Bathroom & Linen closet Addition (This is not a bedroom addition)
The aforementioned site has been evaluated by the Harnett County Health Department
Environmental Health Section. At the time of inspection, there appear to be a septic
system serving this site. If the system should malfunction, the owner is responsible for any
necessary repairs.
BUILDING UST E 5' FROM A PART OF SEPTIC SYSTEM
NOT DRIVE A N SEPTIC SYSTEM
AUTHORIZATION OF E)aSTING SYSTEM
Signature o nvironmental Specialist