HomeMy WebLinkAboutScan From Executive Homes_01222020165112 Public Health Department Camp Fire Septic System
Inspection Report
Environmental Health
Pl 202 Mira Loma Drive T: 530.552.3880 I buttecaun .nett ublichealth
itte t
�� Orovifle, �afifornia 95955 �: 530,538.5339
111117
APN: ti/°\0 -- 1 S o D 11a Owner Telephone: `69 — \ `�
Parcel Address: C 94'1 / '`"L\The_ VY G'A 1'I-IA q s`15`[
Property Owner Name: LS a
Property Owner Mailing Address: .t1.9 IAve, • v C# c=v °5 r
Prior to inspection, contact Butte County Environmental Health for septic records. If no records
are available, 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 1. No❑ In Good Condition: Yes ❑ No 0
Outlet T: Present: Yes)* No❑ In Good Condition: Yes ❑ No ❑
Is Effluent In The Tank At Normal Operating Level? Yes1 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 Load Test.
Introduce water through the outlet_ Minimum of 50 gallons of water.
Signs of Leach Line Failure: Yes ❑ No`
Surfacing Water ❑ Moist Soil ❑ Backflow Into Tank For Over 30 Minutes ❑
Other 0 Explain.
C7\iN C Ar\ O c,9
utte County Certified Profession Phone Number
Eric Dobrich s
Name of Inspector Signature Da e