HomeMy WebLinkAboutAPN-068-060-004_Plans-and-Permits
APN-068-060-004_AIPN.pdf Date:
Updated: December 27, 2016 WHEN RECORDED RETURN TO: COUNTY OF BUTTE PUBLIC HEALTH DEPARTMENT ENVIRONMENTAL HEALTH DIVISION 202 MIRA LOMA DRIVE OROVILLE, CA 95965 SPACE ABOVE FOR RECORDER’S
USE ON-SITE WASTEWATER SYSTEM ACCESS, INSPECTION, AND PERMITTING NOTIFICATION (AIPN) Referenced in On-Site Wastewater Manual as “Notice on Deed” and “Licensing Agreement” Property Identification
Property Owner(s): _______________________________ _______________________________ Property (Site) Address: _______________________________ _______________________________ City State
Zip Trakit Number: _______________________________ APN: _______________________________ Real Property Description: (See Attachment A) System Type Septic tank to pressure
distribution dispersal; Supplemental treatment to pressure distribution dispersal; Other: ____________________________________________ Purpose of the Notification The purpose of
this Notification is to meet the requirements specified in the Butte County On-Site Wastewater Manual for recordation of a Licensing Agreement, and to protect public health by assuring:
1. Compliance with Chapter 19 of the Butte County Code, Kimberly Nedelkow 9 Zepher Way Oroville CA 95966 068-060-004 x Supplemental treatment to gravity seepage pits ON-SITE
WASTEWATER SYSTEM AIPN PAGE 2 OF 6 Updated: December 27, 2016 2. Construction and installation of an adequate on-site wastewater system, hereafter called “System,” as a condition to
the issuance of a building permit for the erection of any residential/commercial structure thereon, 3. Maintenance and renewal of the on-site wastewater system’s Operating Permit, 4.
Assess to the on-site wastewater system as required for monitoring and maintenance, 5. Operation, maintenance, and monitoring (OM&M) of the on-site wastewater system in a manner consistent
with the Butte County On-Site Wastewater Manual, and 6. Information is provided to on-site wastewater system owners wanting more information about the requirements for ongoing permitting,
operation, monitoring, and maintenance, and estimated cost for replacement of their on-site wastewater system. General Provisions 1. The provisions of this AIPN shall bind and inure
to the benefit of the heirs, assigns, and successors in interest of the parties hereto in the same manner as if they had herein been expressly named. This AIPN shall remain in full
force and effect until such time as the County shall execute a release or until such time as the State of California and the County no longer requires monitoring, inspections, and/or
testing of on-site wastewater systems in Butte County. 2. In consideration of the approval of the System by County on the Property, the Owner hereby agrees to defend, indemnify, and
hold County, its employees, officers and agents, free and harmless from any and all claims, damages, and causes of action of every kind, including but not limited to, the amounts of
judgments, interest, court costs, legal fees, and all other expenses incurred by County arising in favor of any party, including personal injuries, death or damages to property (including
employees or property of County) and without limitation by enumeration, all other claims or demands of every character occurring or in any way incident to, in connection with or arising
directly or indirectly out of, the approval, inspection, testing, monitoring or other actions by the County pertaining to System, except to the extent County activities are grossly
negligent or constitute willful misconduct. This provision is not intended to create any cause of action in favor of any third party against Owner or the County, but is intended solely
to provide for indemnification of County as specified above. Operating Permit Requirement 1. The Owner agrees to maintain a valid Operating Permit for the System, and renew the Operating
Permit at the frequency established in the On-Site Wastewater Manual for the type of System maintained. 2. The Owner agrees to utilize a Certified OM&M Specialist to inspect, monitor,
and service the System as a condition for Operating Permit renewal and at a frequency specified in the On-Site Wastewater Manual. Access 1. The Owner grants to the County and its agents,
employees, officers and contract persons access to all portions of the Property upon which the System and appurtenances thereto are located. ON-SITE WASTEWATER SYSTEM AIPN PAGE 3 OF
6 Updated: December 27, 2016 2. The access shall be for the purpose of inspecting, testing, sampling, placing and removing test devices for the purpose of evaluating and monitoring
the System and to investigate the effects of the System or failure thereof. 3. County personnel or designate contract persons shall utilize due care and caution when entering upon the
Property and shall not hold Owner responsible for any injuries or damages that may occur while on the Property that could have been avoided with the exercise of due care and caution.
4. Except in the event of an emergency requiring immediate action to protect the public health and safety, the County shall provide Owner reasonable advance notice (generally, a minimum
of 24 hours) of its intent to enter upon the property. Entry shall be limited to normal business hours unless otherwise arranged with owner. Operation, Monitoring, and Maintenance
1. Treatment, dispersal, and designated repair areas on the Property shall be protected for the System in accordance with Chapter 19 of the Butte County Code and the On-Site Wastewater
Manual. Generally, the areas shall not be used for corrals, pasturing of large animals, building sites or any other use that would impair the System’s operation. Reserve repair installation
areas are shown on the plot plan of the approved System design prepared by the Certified Designer and approved by County. 2. For non-compliant systems, additional fees may be charged
for administration and enforcement. 3. Costs associated with County abatement action in the event the System fails and Owner does not remedy the failure shall be the responsibility
of the Owner. Costs of repair or remediation shall be paid by Owner separate from the costs associated with maintenance of the System’s Operating Permit. 4. Nothing in this AIPN shall
be construed as requiring County to make any of the improvements described, nor shall any provisions of this AIPN be deemed to preclude any other relief provided by law. Additional
Information The Owner may obtain additional information from Butte County Environmental Health regarding the System’s operation, monitoring, and maintenance and estimated costs of System
maintenance and replacement. I understand that this License is for the limited purpose of monitoring as required by the State of California and/or County of Butte. IN WITNESS WHEREOF,
the parties have executed this AIPN this ___ day of ___________________ _____________________, 201 __. ON-SITE WASTEWATER SYSTEM AIPN PAGE 4 OF 5 Updated: December 27, 2016
Approved as to Form I have reviewed this Deed Restriction, set forth above, and it is hereby approved for recordation by the property owner. Signature (Environmental Health Specialist)
Date Printed Name Property Owner I certify that I am the owner of record of the Property and agree to be bound by the provisions set forth herein. Signature Date Printed Name Signature
Date Printed Name ACKNOWLEDGEMENT State of California County of Butte On before me, Notary Public, Name & Title of Officer personally appeared who proved to me on the basis of satisfactory
evidence to be the person (s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies),
and that by his/her/their signatures(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF
PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand & official seal Signature of Notary Public NOTARY SEAL A notary
public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness,
accuracy, or validity of that document. ON-SITE WASTEWATER SYSTEM AIPN PAGE 5 OF 6 Updated: December 27, 2016 Attachment A Parcel Legal Description (Note: Parcel Legal Description
Attached as Page 6)
APN-068-060-004_ConstructionPermit.pdf Microsoft Word - CP Construction Permit March 4 2011.doc
This section completed by applicant APPLICATION Form CP APN #: TrakIt #: Applicant Name (Please print) Property Owner Name Applicant Mailing Address Construction Site Address City
State Zip City State Zip Applicant Telephone Number Certified Designer (if applicable) ☐ New Construction ☐ Repair ☐ Expansion ☐ Tank Destruction Certified Installer (if applicable)
☐ Tank Replacement Only ☐ Residential: Number of bedrooms: ☐ Non-Residential (specify): Applicant Signature Date DESIGN AND CONSTRUCTION APPROVAL This permit is issued based on review
of the attached design and has determined that it meets the re- quirements of Butte County Code Chapter 19 On-Site Wastewater Systems. _ _ Environmental Health Specialist Date of Issuance
Comments/Conditions: � This permit valid only for installation of attached design, stamped “Approved.” Variation from the ap- proved design must have prior approval by Environmental
Health. � This permit valid only if system is installed by the homeowner or by a contractor with valid Installer Certification issued by Environmental Health. � This permit will expire
2 years from the date of Design and Construction approval. This secti FINAL APPROVAL AND CERTIFICATE OF Installation by: ☐ Homeowner ☐ Certified Installer ☐ As-Built Attached
☐ Designer Sign-off Inspected by: Comments: _ Environmental Health Specialist Date White – Environmental Health copy Yellow – Customer copy: Final approval Pink – Customer copy: Permit
Update: December 14, 2020 on completed by Environmental Health ON-SITE CONSTRUCTION P Date: _ Amount: Receipt No. This application will be accepted with payment of permit fee and
the permit will be issued when system design is submitted by a Certified Designer (or Certified Installer for Standard Gravity System) and approved by Environmental Health. 068-060-004
Kimberly Nedelkow Kimberly Nedelkow 9 Zepher Way Oroville CA 95966 Greg Haling, P.E., Haling & Associates x x 3
APN-068-060-004_DesignForm.pdf DATE:
P PR RE ES SS SU UR RE E D DI IS ST TR RI IB BU UT TI IO ON N A AN ND D S SU UP PP PL LE EM ME EN NT TA AL L T TR RE EA AT TM ME EN NT T D DE ES SI IG GN N F FO OR RM M Update:
September 12, 2014 Staff Use Only Date Received: _________ Staff: _________________ A design will be reviewed when this form and design drawings are submitted with an On-Site Wastewater
System Construction Permit application and fees are paid. Parcel Identification APN #: ______________________________ ______________________________________ Applicant Name __________________________
____________ Parcel Address ______________________________________ City State Zip ______________________________________ Subdivision Name/Division/Block/Lot TrakIt #: ______________________________
______________________________________ Designer Name ______________________________________ Designer Mailing Address ______________________________________ City State Zip ___________________________
___________ Designer Telephone Number Design Parameters Treatment Type Vertical Separation (inches) _______________ Closed Bottom Sandfilter Open Bottom Sandfilter Mound ATU _____________________
____ Make/Model Textile Filter _________________________ Make/Model Disinfect Unit_________________________ Make/Model Dispersal Type Gravity Pressure Trench Bed Drain Rock
Gravelles Chamber Subsurface Drip Dispersal System Parameters Number of Bedrooms _______________ Daily Flow ____________gpd Septic Tank Capacity (gal) ____________gal. Receiving Soil
Type (A-E) _______________ Receiving Soil Ap. Rt _________ gpd/ft2 Designed Vertical Separation _______________ Drainfield Square Footage _______________ Percent Reduction Taken _______________
Trench width _________inches Total lineal trench length _____________ft. Trench depth _________inches Depth of fill over drainfield _________inches Slope in drainfield area _____________%
Pump Specifications Difference in Elevation Between Pump Shutoff and Uppermost Orifice: ft Uppermost Orifice is: Lower than Pump Shutoff Capacity @ Total Pressure Head: _______gpm
Calculated Total Pressure Head: ft (Attach Pump Curve) Dosing and Pump Chamber Number of Doses/Day ___________ Dose Quantity _________gal Chamber Capacity _________gal Pump Controls:
Timer (or) Elapse Time Meter (circle if required) If Timer: Pump On _______ Pump Off _______ Check the following components if they drain between doses: port This section completed
by Certified Designer Form DS 068-060-004 Kimberly Nedelkow 9 Zepher Way Oroville CA 95966 Greg Haling, P.E., Haling & Associates 2540 Zanella Way, STE 40 Chico CA 95928
530-342-6958 x Orenco AX20RT □x Seepage Pits 3 Bedrooms 360 1500 E >10ft Pit diameter: 3 ft. Pit Depth 15-35 ft. x 3 Seepage Pits Pressure Distribution and Supplemental Treatment System
Design TrakIt #: ___________________ Update: September 12, 2014 Pressure Distribution System Parameters Laterals Schedule/Class _______________ Length (feet) _______________ Diameter
(inches) _______________ Number _______________ Separation (feet) _______________ Orifices Total Number of Orifices _______________ Diameter (inches) _______________ Spacing (inches)
_______________ Manifold Schedule/Class _______________ Length (feet) _______________ Preferred Manifold Configuration Used? Yes No Transport Pipe Schedule/Class _______________
Length (feet) _______________ Diameter (inches) _______________ Designer Certification The undersigned has submitted this design based observed site conditions and has designed the
system as shown on this design form and the drawings attached thereto. _________________________________________ Designer Date The undersigned has reviewed this design on behalf of
Butte County Public Health Department and determined it to be in compliance with state and local on-site regulations and ordinances. _________________________________________ Environmental
Health Specialist Date Caution: This design approval is only valid when all the following conditions are met: The design is stamped “Approved” by Butte County Public Health Department
The Construction Permit has not expired. The system is installed by a Certified Installer or homeowner authorized by the Butte County Public Health Department Drainfield site
conditions have not been altered to adversely affect conditions of design approval This section completed by Certified Designer This section completed by EH Sch. 40 26 ft. (total)
4 in. 22 ft. Sch. 40 03/06/2023
APN-068-060-004_Improvement-Plans.pdf 03_Disposal-Details
H Haling & Associates &A2540 Zanella Ste. 40 Chico, CA 95928 Phone: (530) 342-6958 SHEET DATE: JOB NO: OF PROJECT SHEET TITLE MAR 2023 03 01 1274 9 ZEPHER WY, OROVILLE, CA APN 068-060-004
ON-SITE WW IMP. PLANS SITE PLAN & SYSTEM LAYOUT SCALE IS IN FEET, BAR IS ONE INCH ON ORIGINAL DRAWING. IF NOT ONE INCH ON THIS SHEET, ADJUST ACCORDINGLY. 5' 10' LEGEND APPROX. PROPERTY
LINE DISPOSAL FIELD SETBACK ROADSIDE DITCH ROAD CENTER LINE 5' SETBACK FROM PROPERTY LINE 1,500-GAL. CONCRETE SEPTIC TANK. SEE DETAIL A/02 MIN. 12' ORENCO AX20RT-MODE1A TREATMENT SYSTEM
SEE DETAIL B/02 SEEPAGE PIT 3-FT. DIAMETER SEE DETAIL A/03 (TYP.) DISTRIBUTION BOX SEE DETAIL D/03 GRAVITY SEWER LINES 4" Ø, SCH. 40 PVC (TYP) SEE DETAIL C/03 5' 6'-8" 2-WAY SEWER CLEANOUT
REPLACEMENT AREA MAINTAIN A 5-FT SETBACK FROM THE FOUNDATION TO ALL SYSTEM COMPONENTS ZEPHER WAY ON-SITE WW IMPROVEMENT PLANS 100% ISSUED FOR CONSTRUCTION 9 ZEPHER WAY, OROVILLE, CA
95966 APN# 068-060-004 LOCATION MAP VICINITY MAP TABLE MOUNTAIN BLVD ORO DAM BLVD ORANGE AVE. HWY-162 HWY-70 MONTGOMERY ST SITE LOCATION SITE LOCATION BURIED ELECTRICAL CONDUIT VERICOMM
120 V AXB CONTROL PANEL MOUNTED TO HOUSE 2' 3' 10' 7' 6'-3" 5' FIELD VERIFY SEWER CONNECTION LOCATION L.L. 30" 18" 68" 55"58" 29" 128" 67" VENT RECIRC. PUMP VAULT SPLICE BOX TO VERICOMM
CONTROL PANEL SPLICE BOX VENT LID RECIRC. TRANSFER LINE SPLICE BOX RECIRC. FILTRATE RECIRC. BLEND RECIRC. RETURN VALVE ORENCO 24"Ø PVC ACCESS RISER WITH GASKETED LID PRTA TANK ADAPTER
72" 46" 0.21" (TYP.) SLOPE TO DRAIN AWAY FROM LID ORENCO BIOTUBE EFFLUENT FILTER 36" 18" 28" 41" 42.5" HIGH LEVEL ALARM HIGH LEVEL OVERRIDE REDUNDANT OFF AND LOW LEVEL ALARM ORENCO
RECIRC. PUMP SYSTEM 62" 102" GRAVITY DISCHARGE TO SEEPAGE PITS A 02 1,500-GALLON CONCRETE SEPTIC TANK DETAIL PLAN (NTS) B ORENCO AX20RT-MODE1A TREATMENT SYSTEM DETAIL PLAN (NTS)
D 1,500-GALLON CONCRETE SEPTIC TANK DETAIL PROFILE (NTS) E ORENCO AX20RT-MODE1A TREATMENT SYSTEM DETAIL PROFILE (NTS) F ORENCO AX20RT SYSTEM DETAIL END VIEW (NTS) C DISCHARGE DETAIL
NTS INVERT 35" FROM BOTTOM OF TANK TO SEEPAGE PITS 02 0202 02 02 GRAVITY DISCHARGE GRAVITY DISCHARGE TO SEEPAGE PITS GRAVITY IN-FLOW FROM HOUSE EXISTING GRADE H Haling & Associates
&A2540 Zanella Ste. 40 Chico, CA 95928 Phone: (530) 342-6958 SHEET DATE: JOB NO: OF PROJECT SHEET TITLE MAR 2023 03 02 1274 9 ZEPHER WY, OROVILLE, CA APN 068-060-004 ON-SITE WW IMP.
PLANS SEPTIC & TREATMENT SYSTEM DETAILS 2" 2" MIN. TYP. 6" MIN MATCH EXISTING GRADE MOUND ABOVE GRADE NATIVE BACKFILL 90% R.C. EXISTING GRADE GRAVITY LINE MINIMUM 2% SLOPE SAND OUTLET
PIPE TO SEEPAGE PITS INLET PIPE FROM AX20RT DROP BOX SHEET DATE: JOB NO: OF PROJECT SHEET TITLE H Haling & Associates &A2540 Zanella Ste. 40 Chico, CA 95928 Phone: (530) 342-6958 NATIVE
SOIL CONCRETE COLLAR MOUNDED MIN. 3" ABOVE NATIVE WATER-TIGHT OBSERVATION PIPE 4-IN. SDR 35 PIPE, PERFORATED BACKFILL WITH MIN. 3-IN. COBBLES. WASHED CLEAN MIN. 15-FT. MAX. 35-FT. SEE
NOTE COMPLETELY FILL HOLE UP TO BOTTOM OF COLLAR WATER-TIGHT LID 36-IN. 24-IN. MIN. 6-IN. MAX. 1-FT. CAP ON OBSERVATION PIPE FROM D-BOX WATER-TIGHT CONNECTION A 03 SEEPAGE PIT DETAIL
PROFILE (NTS) NOTES ENGINEER WILL MONITOR SOIL CUTTINGS WHILE DRILLING. PIT MAY BE SHALLOWER THAN 35-FT IF A CUMULATIVE 3-FT. COLUMN OF USABLE SOIL IS DISCOVERED. OTHERWISE, PIT WILL
BE DRILLED TO A DEPTH OF 35-FT, OR REFUSAL. C NTS TRENCH DETAIL 03 D NTS DISTRIBUTION BOX DETAIL 03 MAR 2023 03 03 1274 9 ZEPHER WY, OROVILLE, CA APN 068-060-004 ON-SITE WW IMP. PLANS
SEEPAGE PIT & MISC. DETAILS CONCRETE COLLAR TO EXTEND DOWN MIN. 6" PAST BOTTOM OF INLET TRENCH EXCAVATION. OUTLINE OF EXCAVATION EDGE OF CONCRETE COLLAR LID OPENING OBSERVATION PIPE
INLET PIPE WATER-TIGHT CONNECTION 3" WASHED COBBLES 60-IN. 60" 36" 24" MIN. 5-IN. MIN. 5" B PLAN (NTS) SEEPAGE PIT DETAIL 03
APN-068-060-004_OperatingPermit.pdf Microsoft Word - OP Operating Permit 151201.doc
O ON N-S SI IT TE E W WA AS ST TE EW WA AT TE ER R S SY YS ST TE EM M O OP PE ER RA AT TI IN NG G P PE ER RM MI IT T Update: December 1, 2015 Date paid: ___________ Amount: ____________
Receipt No. _________ Trakit No.____________ A AP PP PL LI IC CA AT TI IO ON N APN #: ______________________________ ______________________________________ Applicant Name (Please print)
______________________________________ Applicant Mailing Address ______________________________________ City State Zip ______________________________________ Applicant Telephone Number
______________________________________ Property Owner Name ______________________________________ Property Address ______________________________________ City State Zip _____________________________
_________ Certified OM&M Specialist O OP PE ER RA AT TI IN NG G P PE ER RM MI IT T G GE EN NE ER RA AL L I IN NF FO OR RM MA AT TI IO ON N Renewal Frequency: year(s) System type:
Comments/Conditions: _____________________________________________________________________________________________ I IN NI IT TI IA AL L I IS SS SU UA AN NC CE E C
CH HE EC CK KL LI IS ST T Final Approval by LEA Completed As-Built OM&M Manual AIPA Recorded R RE EN NE EW WA AL L I IN NF FO OR RM MA AT TI IO ON N OM&M
Specialist: Inspection Date: No problems noted Problems noted and corrected: It has been determined that this permit meets the requirements of Butte County Code Chapter 19 On-Site
Wastewater Systems. Renewal is based on the information in the attached OM&M Report. Environmental Health Specialist Date Next Renewal Date Note: Operating permits for supplemental
treatment systems expire on December 31. This section completedby applicant This section completed by Environmental Health Form OP 068-060-004 Kimberly Nedelkow Kimberly Nedelkow 9
Zepher Way Oroville CA 95966 TBD