ETHTE #: 12 -5 -29973
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Marshal Johnson Construction Inc. Phone #: 919- 427 -7111
Address: 283 Banner Elk Rd. Benson NC 27504
Name of Mobile Home Park or S /D:
Name of Owner (if different): John & Suzanne MacCallum
Address of Owner (if different): 281 Buffalo Lake Rd. Sanford NC 27332
Property Location (State Road name and ft Buffalo Lake
Purpose of Inspection: room addition
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
WAVE410191121KI 01
AUTHORIZATION OF EXISTING SYSTEM
of Environmental Health Specialist
2
Date