ETHTE #: 15-5-36434
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
Name: John Williams Phone #: 252-291-8023
Address: 4241 Williamson Rd Wilson NC 27893
Name of Mobile Home Park or S/D: Sherwood Acres lot 1
Name of Owner (if different): Joseph Suloff
Address of Owner (if different): 25 Marshall Lane Cameron NC 28326
Property Location (State Road name and #): Marshall Lane
Purpose of Inspection: Storage (24'x30')
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
AUTHORIZATION OF EXISTING SYSTEM
Signature of EnvironmentaIXealth Specialist