ETHTE #: 13 -5 -31791
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
Name: John Holluege Phone #: 541- 285 -3044
Address: 2873 Cameron Hill Rd. Cameron NC 28326
Name of Mobile Home Park or S /D: William E. Bulen lot 2
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and #): Cameron Hill
Purpose of Inspection: covered porch/ built before inspection
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
1 1''' A �
AUTHORIZATION OF EXISTING SYSTEM
9,
/6 11--1,7
of En riv onmental Health Specialist Date