ETHTE #: 15-5-35682
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Shemeka Wilson Phone #: 919-721-4788
Address: 1705 Campbell Dr Sanford NC 27330
Name of Mobile Home Park or S/D: Mason Hill lot 35
Name of Owner (if different): ACA/PJA LLC
Address of Owner (if different): PO Box 3367 Sanford NC 27330
Property Location (State Road name and #): Cool Springs Rd
Purpose of Inspection: Man Home (14'x7
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
WNW W 1. 1 W• 10 1 i
AUTHORIZATION OF EXISTING SYSTEM
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Signature Nnvironmenta ealth Specialist 'Da