HomeMy WebLinkAbout017-160-016 EHDR19-01244 B19-2790 SEPTIC CERTIFICATIONPublie Health Department
Environmental Health
202 Mira Loma Drive
Oroville, California 95965
eamP Fire SePtic SYstem
lnsPection RePort
T: 530'552'3880 i ir.iir*-eoi[,--i;:i.i]-'&lE!-ili!:.ilpdii:
F: 530.538.5339 i
OPtq' Ot 7*ldiQ- O/6 OwnerTelephone:{ seo) boa\ - &os6
Property Owner Maiting Address: l?. B t
Prior to inspection, contact Butte County Environmental Health for septic records. lf no records
are available, an As-Built of the existing tank and leach lines will be required (Form AS).
Septic Tank Phvsical Observations
Tank Material: Concrete ff Fiberglass tr Poly fl Wood (Not lncluding Baffle) [J
lnlet T: Present: Yes ffi NoD ln Good Condition: Yes B No n
OutletT: Present Yesp Non ln Good Condition: YesE No fl
ls Effluent ln The Tank At Normal Operating Level? Yes,V No tr
lf Not, Explain?
ParcelAddress:
Property owner Name: L-"f x rs R.-C<- 1-1 -r sie. A
OverallTank Condition: Good tr
General Comments:
c 4gGo*
Baffle/ Sidewallsi Top Has Visible Cracks/Deterioration: Yes fl NoA'
lf So, Explar". Ck
Fair p Poor tJ
Drain Field Operational Observations
Perform Hydraulic"Load Test.
lntroduce water through the outlet. Minimum of 50 gallons of water.
Signs of Leach Line Failure: Yes D wo ff
Surfacing Water D Moist Soil n Backflow lnto Tank For Over 30 Minutes I
Other I Explain. Ae-ac
Butte County Certified Professional Phone Number
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Name of Signature Date
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lnvoice No.
Job .:i -'
Septic Service
PO Box 8814
Chico, Cd95927
(530) 892-2030
Name
Srreer
r':
Ordered By gal. pumped
....:;:' \ .Sen ice Performed
Remarks:
:"
I
TERlvlS: NET 10 DAYS, a FINANCE CLIARGE *,ill L'e compured on rhe mprid balance ar the rate of I l/2olo per month
InspectionFe. . t'-..'
VacuumTruck ' '-
Materids
CREDITCARD
'u.,.CK
- CHG
Please Pay..
Customer Signature
Sen icenan
"- Service Charge
a:: ., -.;.j.
Phone