ETHTE #: 13 -5 -31094
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
Name: David Hooker Phone #: 919 - 770 -1071
Address: 7203 Broadway Rd. Sanford, NC 27332
Name of Mobile Home Park or S /D: lot 2
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and #): Broadway
Purpose of Inspection: Rolace home with back deck and front porch
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
VA
1 1 1,. MA I' AIR 1 MOWN 01 W I 10101
AUTHORIZATION OF EXISTING SYSTEM
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of Environmental Health Specialist
Date