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ETHTE #: 15-5-35302 HARNETT COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH 307 CORNELIUS HARNETT BOULEVARD LILLINGTON, NC 27546 Name: Jose Ruvalcaba Phone #: 578-6769 Address: 2070 Seneca Dr Fayetteville nc 28301 Name of Mobile Home Park or S/D: Seven Oaks lot 9 Name of Owner (if different): Address of Owner (if different): Property Location (State Road name and #): Marks Rd Purpose of Inspection: Man Home (14'x60') 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 1R MA MW 194'• AUTHORIZATION OF EXISTING SYSTEM 391 Signature of tnvironmeHeafth Specialist