ETHTE #: 13 -5 -31644
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
Name: Junior Ferrell Phone #:
Address: P.O. Box 3092 Sanford NC 27336
Name of Mobile Home Park or S /D:
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and #): Cameron
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
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11MIZEOJ 0 1310 W W11 I'M WAR 1"I MOWN
AUTHORIZATION OF EXISTING SYSTEM
of En iv ronmental Health Specialist
Date