HomeMy WebLinkAbout064-360-031 CAMP FIRE SEPTIC REPORTAssessor's Parcel No:
Owner's Name:
SEPTAGE PUMPER REPORT
HEGENBART SEPTIC TANK CLEANING.
PO BOX 243 MAGALTA CA 95954 530-877-8261
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Evatuation aate _ /j!JP__ Sanitech No.
Phone No.
Property
City, State, Zip:
MailingAddress:,/
Evaluator ,, b "- ,/ 5 -/ 2
- LiceneeNo.
SEPTIC TANK OBSERVATIONS
$cum Depth, lnlet Compartment.....
No [] Yes
No" ffi Yes(-' lnches
Structu ral Tank Condition
inches
[]Good [] Fair $Poor
[ ] High []Normal fi[Low
[] Good ffiFair [ ] Poor
Liquid Operating Level
Baffle Condition..
Septic Tank Volume r aoD Gallons
Addi. TankiVolume Gallons
Riser Condition ..',........[] Good [ ]Fair [] Poar
Sanitary Tee, Outlet ,' . [] No " [Yes
Scum Depth, Outlet Compartment ........... lnches
Sludge Depth. Outlet Compartment............... ... , <? lnches
Tank Material ............ .............,.... [d Concrete t] PolylFiberglass [] Other
Septic Tank Pumping Required... .......0L No [] Yes
Was Septic Tank Pumped ..r.*........... ..... Di[ No [ ] Yes
Date Septic Tank (s) Previously Pumped ...............:... DateDepthToSepticTankAccessLid.,',.''.'...Tlnches
Effluent Pump.....,. 5d No I I Yes
ABSORPTION FIELD OBSERVATIONS
Effluent Line Diverter Valve . 4 No [ ]Yes
\lVell on Property !(l No I I Yes
CommonAreaAbsorption Fie1d.......... ... Fl No [] Yes
Absorption Field Type. ...........:...... . .... H Standard fi Alternative
Surfacing Effluent lil No [ ]Yes
Hydraulic Load Test I No I t YesHydraulicLoadTestResults..... t] Excellent II Good ISatisfactoryr........;....... [] Marginal t I Poor t IFAILURE
Down Slope Seepage kl No [ ]YesSaturatedAbsorptionField..-... []No []Yes
Multiple Systems ......"h1 No [ ] Yes
Graywater Discharge [4No [ ]Yes
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COMMENTS/ OBSERVATIONS
COMMENTS:
b*-P."*- !,or, -
This onsite wasiewater treatment and disposal system evaluation report is a true and complete record of the onsite
wastewater treatment and disposal system on the date of the evaluation. No warranty is given or implied regarding the
remaining life of this system.
I certify that this onsite wastewater treatment and disposal system evaluation report reflecis conditions observed on
the parcel (s) during the routine maintenance of the onsite wastewater treatment and disposal system.
EVALUATOR SIGNAT UAC DATE:z />/z*
LOCATION OF SEPTIC TANK & ABSORPTTON FIELD'
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PARCEL ADDRESS: l .t Zn { po*u,-\, c t.L
*Show all existing structures, wells, water courses, decks , porches, sidewalks and driveways.