ETHTE #: 15-5-36632
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
Name: Eliza Hurley Phone #: 893-5856
Address: PO Box 44 Erwin NC 28339
Name of Mobile Home Park or S/D: Godwin
Name of Owner (if different): Sabrina Hurley
Address of Owner (if different):
Property Location (State Road name and #): Beaver Rd
Purpose of Inspection: Man Home (28'x52')
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 Environmental Heald Specialist
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