ETHTE #: 134-5-31215
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
Name: Adam Edwards Phone #: 919- 356 -8368
Address: 515 Whiffen Rd Cameron NC 28326
Name of Mobile Home Park or S /D:
Name of Owner (if different): David Brogden
Address of Owner (if different): Same
Property Location (State Road name and #): Whiffen Rd
Purpose of Inspection: Man Home (14'x70')
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
�. AUTHORIZATION OF EXISTING SYSTEM
Signature of Environmental Health §pecia t