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ETHTE #: 14 -5 -34464 HARNETT COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH 307 CORNELIUS HARNETT BOULEVARD LILLINGTON, NC 27546 EXISTING SEPTIC SYSTEM INSPECTION Name: Amber Petree Phone #: 919 - 842 -0818 Address: 668 Bullard Rd. Sanford NC 27332 Name of Mobile Home Park or S /D: Buffalo Estates lot 53 Name of Owner (if different): Denice & Louis Giunta Address of Owner (if different): 9341 Royal Melbouine Circle Peyton, CO 80831 Property Location (State Road name and #): Pine Wood Purpose of Inspection: replace home 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 MA 101 11A 'A 1 AUTHORIZATION OF EXISTING SYSTEM lwta Signature of Environmental Health Specialist z y /zc Date