HomeMy WebLinkAbout066-090-035 EHS24-0196 SEPTIC TANK DESTRUCT DECLARATION Public Health Department Cathy A. Raevsky, Director
Andy Miller, M.D., Health Officer
Environmental Health 202 Mira Loma Drive T: 530.552.3880
Oroville, California 95965 F: 530.538.5339
buttecounty.net/publichealth
DECLARATION OF SEPTIC TANK DESTRUCTION
SEPTIC TANK DESTRUCTION PERMITTING PROCESS
1. Complete and submit an On-Site Wastewater Construction Permit application, identifying “Tank
Destruction” as the requested activity when completing the application form.
Note: On-Site Wastewater Construction Permit applications are multi-purpose forms used for permitting septic tank
destruction as well as septic system installation, modification, and repair.
2. Submit with the application the following: (a) Scaled plot plan showing the location of the septic
tank to be destroyed and the location of the replacement septic tank, if applicable, (b) Completed
and signed Declaration of Septic Tank Destruction, and (c) Application fee of $222.
Note: If the proposed septic tank destruction is part of an on-site wastewater system repair, modification, or
replacement for which another On-Site Wastewater Construction Permit is being issued, the septic tank destruction will
be permitted under that application and no additional application or fee will be required for the septic tank destruction
other than completion of this Declaration of Septic Tank Destruction.
3. Follow the Septic Tank Destruction Procedure on the reverse side of this form.
PROPERTY OWNER’S NAME ASSESSOR PARCEL NUMBER
PROPERTY ADDRESS CITY ZIP
CONTRACTOR NAME COMPANY NAME
DESCRIBE METHOD OF DESTRUCTION:
DESCRIBE FILL USED: TANK BOTTOM PERFORATED?
YES NO
COMMENTS:
SIGNATURE OF PERSON PERFORMING WORK PRINT NAME DATE
Form DD
Barbara Bickley
6393 Glendale Ct
Magneson Tractor ServiceLevi Magneson
Magalia 95954
native fill
Perforate tank bottom and crush in place
Levi Magneson 07/22/24
Updated: October 17, 2018
Septic Tank Destruction Procedure
A. The LEA strongly recommends that all work be performed by a Licensed Contractor,
although some work may be done by do-it-yourself property owners with prior LEA
authorization. All work must meet LEA and Building Division requirements and pass
inspection by the LEA.
B. The septic tank must be pumped and certified empty by a Certified Septage Pumper.
C. If the tank is to be destroyed in place and is greater than 5’ from any existing or future
proposed structures, the person performing the work must ensure than the bottom of the
tank is broken such that it is unable to hold water, and then filled with self-compacting soil,
sand, or pea gravel. Should the person performing the work choose to fill the empty tank
with 2-sack slurry, breaking the bottom of the tank is not required. Should the person
performing the work choose to remove the tank, the excavation must be backfilled with
clean self-compacting soil, sand, or pea-gravel.
D. If the tank is less than 5’ from any existing or future proposed structures, a two-sack slurry
mixture must be used to fill the tank; otherwise, a Professional Engineer must certify the
destruction methodology utilized.
E. Arrangements for inspection of the system destruction must be made with the LEA. In some
instances, the Licensed Contractor may be able to submit electronic documentation of the
destruction process in place of an on-site inspection.
F. The person performing the work must submit the Declaration of Septic Tank Destruction
form provided.