HomeMy WebLinkAbout062-730-005 NCDR20-00697 SEPTIC REPORTPublic Health Department North Complex Fire Septic
System Inspection Report
Environmental Health
202 Mira Loma Drive T: 530.552.3880
Oroville, California 95965 F: 530.538.5339
October 16, 2020
buttecounty.net/publichealth
APN:_____________________________ Owner Telephone:__________________________
Parcel Address: _______________________________________________________________
Property Owner Name: _________________________________________________________
Property Owner Mailing Address: __________________________________________________
Prior to inspection, contact Butte County Environmental Health for septic records. If no records
are available, then an As-Built of the existing tank and leach lines will be required (Form AS).
Septic Tank Physical Observations
Tank Material: Concrete □ Fiberglass □ Poly □ Wood (Not Including Baffle) □
Inlet T: Present: Yes □ No□ Condition: Good □ Poor □
Outlet T: Present: Yes □ No□ Condition: Good □ Poor □
Is Effluent In The Tank At Normal Operating Level? Yes □ No □
If Not, Explain. __________________________________________________________
Baffle/ Sidewalls/ Top Has Visible Cracks/Deterioration: Yes □ No □ If So, Explain.___________________________________________________________
Overall Tank Condition: Good □ Fair □ Poor □
General Comments: ______________________________________________________
______________________________________________________________________
Drain Field Operational Observations
Perform Hydraulic Test of Effluent Line to Dispersal Field
Introduce water through the outlet. Minimum of 50 gallons of water.
Signs of Effluent Line Break or Leach Field Failure *: Yes □ No □
Surfacing Water □ Moist Soil □ Backflow into Tank for Over 30 Minutes □
Other □ Explain. ___________________________________________________________
____________________________________________________________________________
Butte County Certified Professional (Business Name) Phone Number
Name of Inspector Signature Date
* This hydraulic test of the effluent line does not constitute a full hydraulic load test of the dispersal
field. A full hydraulic load test can only be effectively done with more water and when the system
has been in continual use.
E-mail completed report to BCLandUse@buttecounty.net