ETHTE #: 14 -5 -32870
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
Name: Keith Muse Phone #: 709 -7900
Address: 264 Carl McLean Rd Bunnlevel NC 28323
Name of Mobile Home Park or S /D:
Name of Owner (if different): Rodean Anderson
Address of Owner (if different): 5139 Rabor Ct Fayetteville, NC 28303
Property Location (State Road name and #): Sanderfer Rd
Purpose of Inspection: Man Home Placement (14'x76')
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 C '• 0 '
I120[ij 0 " IN Ly'd Null 1114 6T-11 N94 we
AUTHORIZATION OF EXISTING SYSTEM
Signature of Environmental Health Specialist