ETHTE #: 13 -5 -31391
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
Name: James Jackson Phone #:
Address:
Name of Mobile Home Park or S /D:
Name of Owner (if different): David Camping
Address of Owner (if different): 1401 Perrin Dr North Myrtle Beach SC 29582
Property Location (State Road name and ft 1259 Collins Rd
Purpose of Inspection: Deck
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
1LIZIMIJ 8 11 .1 ALI IN MIJIM-1
ORIZATION OF EXISTING SYSTEM
Signature of Environmental Health