ETHTE #: 13 -5 -30993
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
Name: Alfredo Muldanado Phone #: 919 -931 -7881
Address: 141 Lori Ln. Sanford NC 27332
Name of Mobile Home Park or S /D: K Bar Hills lot 12
Name of Owner (if different): BK Properties
Address of Owner (if different): 1945 Pickard Rd. Sanford NC 27332
Property Location (State Road name and #): Lori
Purpose of Inspection: replace home
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
L110111 0 03 " W41 " ', 1
AUTHORIZATION OF EXISTING SYSTEM
I
ofrnviromnental Health Specialist
Date