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ETHTE #: 09 -5 -21418 & 12 -5 -29729 HARNETT COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH 307 CORNELIUS HARNETT BOULEVARD LILLINGTON, NC 27546 EXISTING SEPTIC SYSTEM INSPECTION Name: Jeff & Barbara Salter Phone #: 919- 356 -9816 Address: 200 Donna Lynn Lane Cameron, NC 28326 Name of Mobile Home Park or S /D: Doyle Wicker Jr. lot 3 Name of Owner (if different): Address of Owner (if different): Property Location (State Road name and #): Hilmon Grove Purpose of Inspection: Mod & detached awe 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 BUILDING MUST BE 5' FROM ANY PART OF SEPTIC SYSTEM DO NOT DRIVE OR PARK ON SEPTIC SYSTEM AUTHORIZATION OF EXISTING SYSTEM of 15hvironm6ntal Health Specialist �.s' / z °/ 2-- Date