ETHTE #: 15-5-36642
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
Name: Marc Thomsen Phone #: 910-580-3360
Address: 155 Blanchard Rd. Sanford NC 27332
Name of Mobile Home Park or S/D: Overview Estates lot 4
Name of Owner (if different): Rhonda Niccum
Address of Owner (if different):
Property Location (State Road name and #): Blanchard Rd.
Purpose of Inspection: detachedag rage
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
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Signature
AUTHORIZATION OF EXISTING SYSTEM
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Health Specialist
Date