ET RRHTE #: 12- 5- 29729RR 09- 5- 21418RR
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
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Name: Jeff Salter Phone #: 910- 305 -7238
Address: 200 Donna Lynn Ln Cameron NC 28326
Name of Mobile Home Park or S /D: Doyle Wicker lot 3
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and ft 1106 Hillmon Grove
Purpose of Inspection: SFD & Det Garage
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
D I t -4 61 DJ 12
AUTHORIZATION OF EXISTING SYSTEM
Signature of `Environment health Specialist
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Date