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ET RHTE #: 12- 5- 29909R HARNETT COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH 307 CORNELIUS HARNETT BOULEVARD LILLINGTON, NC 27546 Name: Timothy Redwine Phone #: 919 - 498 -4001 Address: 115 Washington Ave. Sanford, NC 27332 Name of Mobile Home Park or S /D: GW McIver lot 1 Name of Owner (if different): Earl Redwine /Vivan Prince Address of Owner (if different): P.O. Box 321 Olivia NC 28368 Property Location (State Road name and #): Surefire In Purpose of Inspection: expired permits 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 J 0 1 IN M1 W-1 14 WAR 12 MINGO 01 W I INKWIN N 0101 AUTHORIZATION OF EXISTING SYSTEM P._ m,;-- Signdture of Ennvironmental Health Specialist Date