ETHTE #: 15-5-35931
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
Name: Elder Harold Hughes Phone #: 919-478-8703
Address: 109 Vail Ct Sanford NC 27332
Name of Mobile Home Park or S/D:
Name of Owner (if different): Teach All Nations Ministries
Address of Owner (if different): 12254 Hwy 2105 Spring Lake NC 28390
Property Location (State Road name and #): NC210S
Purpose of Inspection: Shed (16'x20')
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
1 t'1I MA OW111114'. 4,14 MIJIM]
AUTHORIZATION OF EXISTING SYSTEM
Signature of Environmental Health Specialist