ETHTE #: 13 -5 -31809
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
C414 f,-6 LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Shaw Construction Phone #: 483 -2904
Address: 1248 Bill Shaw Rd Spring Lake NC 28390
Name of Mobile Home Park or S /D:
Name of Owner (if different): First Choice Comm Health Care
Address of Owner (if different): 40 Autumn Fern Trail Lillington NC 27546
Property Location (State Road name and #): Hwy 87
Purpose of Inspection: Office Space (29'x17')
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
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Signature of Environmental Heait i * ecialist
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