ETHTE #: 15-5-36692
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
Name: Smith, Ronald 7 Meyers, Catherine Phone #: 919-662-1191
Address: 338 Docs Rd Lillington NC 27546
Name of Mobile Home Park or S/D:
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and #): Docs Rd
Purpose of Inspection: Shed (40'x36')
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
111MIZIOM 0 CA MA
i.',' MUNRO I Wd I Iffif MMMA
AUTHORIZATION OF EXISTING SYSTEM
Signature of Environmenta 0 Specialist Date