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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
Supplemental fields
FilePath
\MIGRATIONS\W\WALNUT GROVE\13945\CO0043361.PDF
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EHD - Public
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RECEIVED 04/03/2017 10:54AM <br /> Apr 0317, 10:00a River Rats Septic 9167762736 p.3 <br /> CERTIFICATE OF SEPTIC INSPECTION <br /> River Rats Septic & Plumbing Services N2 1534 <br /> P.O. Box 365 a Walnut Grove, CA 95690 <br /> 916-776-1600 • Fax 916-776-2481 <br /> Owner's NameL25.u�? \W Phone ,20 7 2 !L a( 2-77 <br /> Billing Address �NNi W1 n t 7 6- a� L�ca x..33_!g6 <br /> Job Address Escrow# <br /> Date Pumped 3 —\G— 1 Capacity Parcel# <br /> TANK CONSTRUCTION <br /> 0 CEMENT ❑ FIBERGLASS ❑ OTHER <br /> CONDITION OF BAFFLE &VENT SPACE <br /> ❑ OK ❑ CEMENT ❑ REDWOOD ❑ OTHER <br /> CONDITION OF LIDS <br /> ❑OK ❑ NEEDS TO BE REPLACED ❑ OTHER <br /> CONDITION OFT'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 /> O, Leach field shows signs of failure. <br /> ❑ Liquid level of tank was normal. PUMP SEPTIC <br /> ❑ Liquid level of tank was over tank T's to lids_ <br /> ❑ Necessary repairs made-system OK. HRS./LOCATE DIG UP <br /> ❑ Imminent Failure- system could fail at any time. <br /> ❑ DATE LAST PUMPED_ �$ P/H =$ <br /> ❑ AS BUILT: LID DEPTH REPAIRS: MEN <br /> v r'� & V HRSJLABOR =$ <br /> c D ��as MATERIAL =$ <br /> IaL\�a jj,'bj� <br /> TAX =$ <br /> CAMERA =$ <br /> LOCATOR <br /> Loa, G� i:RY',P*k =$ �•�� n'J <br /> Recommendations: _$ <br /> a$ <br /> TOTAL DUE =$ % 00- <br /> Ahthorized <br /> Signature: DATE PAID: j <br />
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