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ETHTE #: 14 -5 -33712 HARNETT COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH 307 CORNELIUS HARNETT BOULEVARD LILLINGTON, NC 27546 EXISTING SEPTIC SYSTEM INSPECTION Name: David Meadows Phone #: 574 -2579 Address: 953 McKimmon Dr Fayetteville NC 28306 Name of Mobile Home Park or S /D: Name of Owner (if different): Allen Lasater Address of Owner (if different): 180 Four Corners Ln Broadway Property Location (State Road name and #): Buie Rd Purpose of Inspection: Pool 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 I U W OKI] AN W, AUTHORIZATION OF EXISTING SYSTEM 0ME Signature of Environmeht#Wealth Specialist