ETHTE #: 15-5-36391
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Charles Lynn Phone #: 919-796-6128
Address: 399 Chatam In Cameron, NC 28326
Name of Mobile Home Park or S/D: Viranda lot 1
Name of Owner (if different): Christina Boada
Address of Owner (if different):
Property Location (State Road name and #): Elirea Ln
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
6A W W1Z-11 R W111=11
AUTHORIZATION OF EXISTING SYSTEM
MW
Environmental flealth Specialist
2�1s'
Date