ETHTE #: 13 -5 -30615
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Michael F. Warren Phone #: 910- 303 -7079
Address: 4280 Ray Rd. Spring Lake, NC 28390
Name of Mobile Home Park or S /D: ERC IV lot 18
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and ft Palmer Walker
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
114AW4i 0 11,114 W W01 1114 ALI t14 t
AUTHORIZATION OF EXISTING SYSTEM
ignature of Environmental Health Specialist Date