ET RHTE #: 10- 5- 2485OR
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
Name: Real Life Church Phone #:
Address: 1994 Ray Rd Spring Lake NC 28390
Name of Mobile Home Park or S /D:
Name of Owner (if different): Linda Kennedy
Address of Owner (if different): PO Box 194 Woodlawn TN 37191
Property Location (State Road name and #): Ray Rd
Purpose of Inspection: Mod Classrooms
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
119JOIJ 0 13 IN MA MW k"a 11 11 1 ON M
AUTHORIZATION OF EXISTING SYSTEM
Signature of Environmental H peciali