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CO0043361
EnvironmentalHealth
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WALNUT GROVE
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4200 – Liquid Waste Program
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CO0043361
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Last modified
6/10/2019 4:55:25 PM
Creation date
2/13/2019 11:08:43 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200 – Liquid Waste Program
RECORD_ID
CO0043361
PE
4200
FACILITY_NAME
NEW HOPE RV PARK & MARINA
STREET_NUMBER
13945
Direction
W
STREET_NAME
WALNUT GROVE
STREET_TYPE
RD
City
THORNTON
Zip
95686
APN
00104005
ENTERED_DATE
4/26/2017 12:00:00 AM
SITE_LOCATION
13945 W WALNUT GROVE RD
RECEIVED_DATE
4/26/2017 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\wng
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FilePath
\MIGRATIONS\W\WALNUT GROVE\13945\CO0043361.PDF
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EHD - Public
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A RECEIVED 04/03/2017 10:54AM <br /> Apr 0317,10:00a River Rats Septic 9167762736 p.2 <br /> CERTIFICATE OF SEPTIC INSPECTION <br /> River Rats Septic & Plumbing Services N° 1590 <br /> P.O. Box 365 a Walnut Grove, CA 95690 <br /> 916-776-1600 • Fax 916-776-2481 <br /> Owner's Name Ileci <br /> l, r / ' LG1n Phon�e,11a/o9-7�y— dwa� <br /> Billing Address 139 <br /> r l'� hkGnat 6CLQ l-( ( ` <br /> Job Address Escrow# <br /> Date Pumped Capacity Parcel # <br /> TANK CONSTRUCTION <br /> ❑ CEMENT ❑ FIBERGLASS ❑OTHER <br /> CONDITION OF BAFFLE &VENT SPACE <br /> CtOK ❑ CEMENT ❑ REDWOOD ❑ OTHER <br /> CONDITION OF LIDS <br /> ❑ OK ❑ NEEDS TO BE REPLACED ❑ OTHER <br /> CONDITION OF T'S <br /> ❑OK ❑ NEEDS TO BE REPLACED (T9.CODE) ❑ OTHER <br /> SEPTICTANK & LEACH FIELD CONDITION INVOICE <br /> ❑ Leach field appears to be working OK at this time. <br /> ❑ Leach field shows signs of failure. <br /> ❑ Liquid level of tank was normal_ PUMP SEPTIC =$ <br /> ❑ Liquid level of tank was over tank Ts to lids. <br /> ❑ Necessary repairs made - system OK. HRS./LOCATE DIG UP <br /> ❑ Imminent Failure -system could fail at any time. <br /> 13 DATE LAST PUMPED_ - 0$_PIH -$ <br /> REPAIRS: MEN <br /> ❑ AS BUILT: LID DEPTH <br /> S J r�r HRSJLABOR =$ <br /> �-y ) n Ew Cis MATERIAL =$ <br /> ` .- TAX =$ <br /> CAMERA =$ <br /> LOCATOR =$ <br /> Labor- i- _AAa r, l=$ 6 R. <br /> Recommendations: =$ <br /> TOTAL DUE --$ , — <br /> Authorized DATE PAID: <br /> Signature: <br />
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