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Home My WebLink About058-520-005 EHDR19-12913 SEPTIC REPORT CAMP FIRE 7.3.24Public Health Department 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: _________________________________________________________ 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 (058-520-005 530)282-6973 4189 Back Ache Rd Mike Nimz ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ Tom’s Septic (530)533-6095 Vincent Jasinsky 07/03/24 PO Box 4074 Oroville, CA 95965Property Owner Mailing Address: __________________________________________________ !"#$ %&'( )($*&+ ),-*(# ./-$(+*&0/ 1($0'*