ETHTE #: 14-5-34895
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
Name: Gerald Mickie & Estelle Grier Phone #: 919-321-9933
Address: 4372 Olivia Rd Sanford NC 24332
Name of Mobile Home Park or S/D:
Name of Owner (if different): Gregory & Lisa Christian
Address of Owner (if different): PO Box 173 Olivia NC 28308
Property Location (State Road name and #): 4372 Olivia Rd
Purpose of Inspection: Man Home (14'x70')
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
Signature of
MA W016VI-11 1114 1
AUTHORIZATION OF EXISTING SYSTEM
Specialist
1 ) `'3 i
Date