ETHTE #: 15-5-36946
HARNETT COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH
307 CORNELIUS HARNETT BOULEVARD
LILLINGTON, NC 27546
EXISTING SEPTIC SYSTEM INSPECTION
Name: Rene Martinez Phone #: 261-6350
Address: 1501 Hope Mills Rd Fayetteville NC 28304
Name of Mobile Home Park or S/D: Jaylin Oaks lot 7
Name of Owner (if different): Victor Basher
Address of Owner (if different): 121 Jaylin Blvd Spring Lake NC 28390
Property Location (State Road name and #): 121 Jaylin Blvd
Purpose of Inspection: Deck (14'x19')
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
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6A LTA DKII Oka 6VI-11 1,A NE110
AUTHORIZATION OF EXISTING SYSTEM
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Signature of Environm*Health Specialist