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ETHTE #: 14 -5 -32796 HARNETT COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH 307 CORNELIUS HARNETT BOULEVARD LILLINGTON, NC 27546 EXISTING SEPTIC SYSTEM INSPECTION Name: Christine Williams Phone #: 910- 890 -4099 Address: 184 Rodeo Ln 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 #): McDou alg d Rd Purpose of Inspection: Attached Storage Building (30'x50') 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 11-1111101, , , � 1 AUTHORIZATION OF EXISTING SYSTEM a� �-�'-lam? Signature of vironmental Hea1t ecialist Date