ETHTE #: 14-5-34877
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
Name: Jacques Robertson Phone #: 307-220-3808
Address: 317 Williams Dr Benson NC 27504
Name of Mobile Home Park or S/D:
Name of Owner (if different): Bober Flowers
Address of Owner (if different): 1498 Raynor McLamb Rd Linden NC 28356
Property Location (State Road name and #): Raynor McLamb Rd
Purpose of Inspection: Deck (18'x16')
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
.11 MA Wei' A-11 9114 MIN&I
AUTHORIZATION OF EXISTING SYSTEM
Signature of Elivironmental``� ealth Specialist