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ETHTE #: 15-5-35448 HARNETT COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH 307 CORNELIUS HARNETT BOULEVARD LILLINGTON, NC 27546 Name: Philip Arevalo Phone #: 584-7715 Address: 200 Mamie Ferguson Dr Lillington NC 27546 Name of Mobile Home Park or S/D: Mamaie Bell Ridge lot 31 Name of Owner (if different): Address of Owner (if different): Property Location (State Road name and #): Old US421 Purpose of Inspection: Garage & Inground Pool 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 t 1N W OKI]!A1111.1,xvion AUTHORIZATION OF EXISTING SYSTEM Signature of Environmental Specialist M