ETHTE #: 14-5-35099
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Willie Underwood Jr. Phone #: 919-770-7745
Address: 5152 Sheriff Watson Rd. Sanford. NC 27330
Name of Mobile Home Park or S/D:
Name of Owner (if different): Calvary Missionary Church
Address of Owner (if different): 185 Calvary Church Rd
Property Location (State Road name and #): calvary church
Purpose of Inspection: addition
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 1 •' '
OULU 0HIR LTA MW O IA M131=3
AUTHORIZATION OF EXISTING SYSTEM
of Environmental Health Specialist
zC lzc6—
Date