ETHTE 12-5-29014
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Michael & Heather Furhman Phone 931-538-5990
Address: 377 Tactical Dr Bunnlevel NC 28323
Name of Mobile Home Park or S/D: Gwen Oaks lot 23
Name of Owner (if different):
BUILDING UST E 5' FROM A PART OF SEPTIC SYSTEM
NOT DRIVE OR A N SEPTIC SYSTEM
AUTHORIZATION OF EXISTING SYSTEM
Signature of Environmental