ETHTE #: 12 -5 -29909
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
Name: Timothy Redwine Phone #: 919 - 777 -2929
Address: 1115 Washington Ave. Sanford, NC 27330
Name of Mobile Home Park or S /D: GW McIver lot 1
Name of Owner (if different): Earl Redwine /Vivan Prince
Address of Owner (if different): PO Box 321 Olivia NC 28368
Property Location (State Road name and #): Love Grove Church
Purpose of Inspection: replace mh
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
1'i i 1 '�' i M10110001 0 "
AUTHORIZATION OF EXISTING SYSTEM
of En nmental Iftealth Specialist
G 2j' 2t/
Date