ETHTE #: 13 -5 -31446
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
Name: Denise Spivey Johnson Phone #: 919- 499 -2398
Address: 795 Big Branch Rd. Sanford, NC27332
Name of Mobile Home Park or S /D:
Name of Owner (if different): Catherine Spivey
Address of Owner (if different): 190 McCormick Rd
Property Location (State Road name and #): McCormick
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
c
1� 11 MA all . . IDA 9
AUTHORIZATION OF EXISTING SYSTEM
Health Specialist
C // V/S -1_7
Date