ETSITE #: 13 -5 -32388
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Angus Ray Phone #: 237 -3255
Address: 456 Bill Shaw Rd Spring Lake NC 28390
Name of Mobile Home Park or S /D: Angus J Ray lot of 5
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and ft Bill Shaw Rd
Purpose of Inspection: Modular 68'x30')
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
G 1 1 .;1 •' ! I
AUTHORIZATION OF EXISTING SYSTEM
Milo
Signature of Environmentaalth Specialist / Date