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Home My WebLink About027-290-001 SEWW23-0038 SITE EVALUATIONOONN--SSIITTEE WWAASSTTEEWWAATTEERR SSIITTEE EEVVAALLUUAATTIIOONN FFOORR NNEEWW DDEEVVEELLOOPPMMEENNTT Update: January 28, 2015 Date paid: ____________ Amount: _____________ Receipt No. __________ AAPPPPLLIICCAATTIIOONN APN #: ______________________________ ______________________________________ Applicant Name ______________________________________ Applicant Mailing Address ______________________________________ City State Zip ______________________________________ Applicant Telephone Number TrakIt #: ______________________________ ______________________________________ Property Owner Name ______________________________________ Site Evaluation Parcel Address ______________________________________ City State Zip Evaluation for:  Residential use  Commercial use Number of bedrooms or parcels (or description of intended use if non-residential): Name of Certified Designer (if applicable): Name of Certified Installer (if applicable):  Site Evaluation application complete and fees paid *  Directions to site attached and site flagged *  Site plan attached (use checklist included in this application) * - and one of the following -  Test holes excavated in manner described in On-Site Manual * -or-  Certified Installer/Designer will contact staff to schedule site inspection and soil evaluation * *Items that must be completed before on-site evaluation takes place Official Use Only – Do Not Write Below This Line OOBBSSEERRVVEEDD SSIITTEE CCHHAARRAACCTTEERRIISSTTIICCSS OOFF DDIISSPPEERRSSAALL SSYYSSTTEEMM PPLLAACCEEMMEENNTT AARREEAA Parcel Size: _______ acres Slope in drainfield area: _______% Slope in repair area: _______% Effective soil depth: __________ inches Type of restrictive layer:  Impermeable  Seasonal groundwater  Excessively drained  N/A Horizontal setback requirements can be met:  Yes  No  Need scaled site plan Soil log data attached:  Yes  No Form SE This section completed by applicant EH Staff or Certified Designer Benjamin Rodriguez Armando Silvas 634 Falling Rock Court 027-290-001 Yuba City CA 95991 916-296-2411 0 Mackintosh Ave Oroville CA 95966 x Future construciton of single family home, up to 4 bedrooms. X X X X Site Evaluation TrakIt #: Page 2 Update: January 28, 2015 AADDDDIITTIIOONNAALL TTEESSTTIINNGG  N/A, no additional testing required for completion of this evaluation  Additional test holes required  Percolation testing required (Site Evaluation cannot be completed until this task performed)  Seasonal groundwater monitoring required (Site Evaluation cannot be completed until this task performed) (After additional testing has been completed, attach RREESSUULLTTSS.) EEVVAALLUUAATTIIOONN RREESSUULLTTSS Wastewater System Type  Standard Gravity  Non-Standard Gravity  Pressure Distribution  Supplemental Treatment  Disinfection or engineered fill Dispersal System Requirements Application Rate ____ gpd/ft2 based on:  Soil texture  Percolation rate  Soil data from original map Minimum vertical separation __________ inches Depth of curtain drain __________ inches  N/A, curtain drain not required Special Design Considerations/Comments ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Determination when Designer Required I have determined that an onsite wastewater sys- tem for this site can be designed and approved meeting the requirements of Butte County Code Chapter 19 and the Butte County On-Site Wastewater Manual provided the design parame- ters specified in this Site Evaluation are utilized. System Designer Date I have reviewed this site in conjunction with the Certified Designer and concur with the Designer’s assessment as certified above. Environmental Health Specialist Date Determination when Designer Not Required I have determined that an onsite wastewater system for this site can be designed and approved meeting the requirements of Butte County Code Chapter 19 and the Butte County On-Site Wastewater Manual provided the design parameters specified in this Site Evaluation are utilized. Environmental Health Specialist DateThis section completed by Environmental Health Staff or Certified Designer Note: This Site Evaluation may be invalidated should one of the following occur: (1) The type of use will be differ- ent than what was indicated in this application, (2) Site conditions are altered, adversely impacting the drainfield or reserve areas, or (3) New information becomes availa- ble clearing indicating the that findings or conclusions of the Site Evaluation were incorrect and an adverse impact to water quality or public health would result if the evalu- ation was not altered or invalidated. Update: January 28, 2015 SITE EVALUATION SITE PLAN CHECKLIST Owner’s name Assessor’s Parcel Number North arrow Property lines Any relevant site features such as cliffs, cut banks, irrigation canals, springs, rock outcrop, landslide areas, drainage ways, etc/ Any existing and/or proposed site improvements, such as wells, buildings, pools, driveways, etc. (please specify whether existing or proposed) Existing wastewater dispersal areas, if present Proposed primary and repair wastewater dispersal areas Test hole locations (if already excavated at the time of applicationThis section completed by applicant x x x x x x x x x Update: January 28, 2015  Armando Silvas Benjamin Rodriguez 916-296-2411 0 2 7 2 9 0 0 0 1 N 2994 Mackintosh Ave, Oroville, Ca 95965 In Oroville (Just outside of Palermo), South end of Reservoir Rd, Approx. 2500 ft south of Utah Ave. See attached map. 9/18/23 1"=100' 100'-0" Mackintosh Ave Resevoir RdN Proposed House Location Proposed Septic System Location (Test Hole 1) Reserve Septic Location (Test Hole 2)218'-1/4"230'-1 1/2" 65'-4 3/4"199'-2 1/4"Approx. 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