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ETHTE #: 12 -5 -29646 HARNETT COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH 307 CORNELIUS HARNETT BOULEVARD LILLINGTON, NC 27546 EXISTING SEPTIC SYSTEM INSPECTION Name: Clanton Homes Phone #: 910 - 424 -8602 Address: 3341 Allespin St. FUettville, NC 28326 Name of Mobile Home Park or S /D: Longleaf lot 45 Name of Owner (if different): James Davis Address of Owner (if different): 405 Pittman Rd Property Location (State Road name and #): 27 w Purpose of Inspection: replace home 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 11 MA DKII 1114 6TI-11 I" NOW" D1 W I AUTHORIZATION OF EXISTING SYSTEM — ZL�� t of Environmental Health Specialist WAM Date