ETHTE #: 13 -5 -32238
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
1
Name: Tommie & Barbara Campbell Phone #: 978 -6250
Address: 8600 NC27W Lillington NC 27546
Name of Mobile Home Park or S /D:
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and #): 2038 Fire Lane Rd
Purpose of Inspection: Man Home Placement (30'x56')
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
I: 1 1 " • 0 1
111201110 11 ' all ta W.111 13 101913010
AUTHORIZATION OF EXISTING SYSTEM
Signature of Environmental
Specialist
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