ETHTE #: 15-5-36863
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
Name: Tonya Gray Phone #: 919-721-2210
Address: 1299 McArthur Rd Broadway NC 27505
Name of Mobile Home Park or S/D: Angela Byrd lot 1
Name of Owner (if different):
Address of Owner (if different):
Property Location (State Road name and #): 1280 McArthur Rd'
Purpose of Inspection: Mod (32'x80')
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
N MIA 101 ta Ally ILA W1109-0 D1 W I
AUTHORIZATION OF EXISTING SYSTEM
BMW
Signature of Environme'Iealth Specialist