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ETHTE #: 14-5-35077 HARNETT COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH 307 CORNELIUS HARNETT BOULEVARD LILLINGTON, NC 27546 Name: Hugo Santos Phone #: 919-356-6573 Address: 27 Gunter Lake Rs Sanford NC 27332 Name of Mobile Home Park or S/D: Name of Owner (if different): James Phillips Address of Owner (if different): 471 Doyle Cox Rd Sanford NC 27330 Property Location (State Road name and #): Knight_ Rd Purpose of Inspection: Man Home Placement (14'x60') 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 Off W ti i ),3 MA *13 ta MEN CIA MIN AUTHORIZATION OF EXISTING SYSTEM 0 Signature of viron nta alth Specialist