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ETHTE 11-5-27336 HARNETT COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH 307 CORNELIUS HARNETT BOULEVARD LILLINGTON, NC 27546 EXISTING SEPTIC SYSTEM INSPECTION Name: Starretta Lopez Phone 919-343-0153 Address: 555 Asset Parkway Sanford, NC 27332 Name of Mobile Home Park or S/D: William T. Anderson Name of Owner (if different): Address of Owner (if different): Property Location (State Road name and 27 west Purpose of Inspection: Replace MH 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 BUILDING MUST BE 5' FROM ANY PART OF SEPTIC SYSTEM DO NOT DRIVE OR PARK ON SEPTIC SYSTEM AUTHORIZATION OF EXISTING SYSTEM lv/ G (z o// Signature onvironmental Health Specialist Date