ETHTE #: 13 -5 -32383
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
Name: Michael Warren Phone #: 489 -0669
Address: 4280 Ray Rd Spring Lake NC 28390
Name of Mobile Home Park or S /D: ERC IV lot 18
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and #): Palmer Walker Rd
Purpose of Inspection: Man Home (24'x56') Placement
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
11 1 t' 'A W 503 F1 11.3 "1 W11125-3 '
AUTHORIZATION OF EXISTING SYSTEM
Signature of Environmental lth Specialist
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