ETHTE #: 13 -5 -30812
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Tori Hollingsworth Phone #: 910 - 242 -2426
Address: 1260 Fire Lane Rd. Bunnlevel NC 28323
Name of Mobile Home Park or S /D:
Name of Owner (if different): Robert Earl Davis
Address of Owner (if different): 63 Aucuniber Ln. Linden, NC 28356
Property Location (State Road name and #): McLean Chapel Church
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
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AUTHORIZATION OF EXISTING SYSTEM
of Environmental Health Specialist
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Date