ETHTE #: 12 -5 -30027
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Oscar Ramirez Mendez Phone #: 919- 935 -9443
Address: 117 Vista Ridge Trail Sanford NC 27332
Name of Mobile Home Park or S /D: Lineberger lot 3 Cj �,E
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and #): 1203 Calvary Churh Rd
Purpose of Inspection: Man. Home Placement (14'x72')
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
1t 1' e' '•
ORIZATION OF EXISTING SYSTEM
Signature of Environmental Health
010EM
Date