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SR0078383
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0078383
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Entry Properties
Last modified
6/27/2018 2:03:54 PM
Creation date
3/2/2018 8:18:33 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0078383
PE
4214
FACILITY_NAME
JESSICA TRINKLE
STREET_NUMBER
1A018
STREET_NAME
EVERGREEN
City
TRACY
Zip
95304
APN
80101018
ENTERED_DATE
3/2/2018
SITE_LOCATION
30000 KASSON RD 1A018 EVERGREEN
RECEIVED_DATE
11/13/2017
P_LOCATION
99
P_DISTRICT
005
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SEPTIC SYSTEM INSPECTION CHECK LIST <br />ADDRESS: 3600p KcisSor,)/ <br />C K <br />PERMIT # 5120 v j <br />Check box <br />PARAMETER if inspected <br />ACTUAL <br />MEASUREMENT <br />MEETS SJC <br />STANDARDS? COMMENTS <br />SEPTIC TANK: <br />CORRECT TANK CAPACITY? <br />DISTANCE TO FOUNDATION? <br />DISTANCE TO PROPERTY LINE? <br />DISTANCE TO ANY WELLS? <br />TANK LEVEL AND ORIENTED CORRECTLY? <br />SANITARY TEES CORRECTLY INSTALLED? <br />CORRECT TYPE OF PIPING? <br />TANK VENTED ? <br />ANY TANK ABNORMALITIES NOTED? <br />OTHER <br />X20 <br />/,31 <br />Sp 1236 <br />0 <br />Y <br />Y <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />DISTRIBUTION BOX: <br />DISTANCE FROM TANK? <br />DISTANCE TO NEAREST LEACH LINE? <br />DOES SYSTEM HAVE EQUAL DISTRIBUTION?-' <br />IS D -BOX LEVEL?—� <br />OTHER <br />�. <br />S <br />3 -J <br />Y <br />Y <br />N <br />N <br />N <br />N <br />N <br />LEACH FIELD: (LL = LEACH LINES) <br />DISTANCE TO PROPERTY LINE? <br />DISTANCE TO ANY WATER WELLS? <br />DISTANCE TO NEAREST FOUNDATION? <br />DISTANCE OF SOIL BARRIER BETWEEN LL'S? <br />CORRECT DEPTH OF LL TRENCHES? <br />CORRECT DEPTH AND TYPE OF ROCK? <br />CORRECT WIDTH OF LL TRENCHES? <br />CORRECT LENGTH OF LL TRENCHES? <br />CORRECT TYPE OF PIPING? <br />OTHER <br />_�- <br />Z� <br />- <br />s <br />�� 'rte t,S <br />SP R 35- <br />Y <br />Y <br />Y <br />Y <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />f <br />f <br />SEEPAGE PITS: N <br />DISTANCE TO PROPERTY LINE? <br />DISTANCE TO ANY WATER WELLS? <br />DISTANCE TO NEAREST FOUNDATION? <br />DISTANCE OF SOIL BARRIER TO PITS? <br />CORRECT DEPTH AND TYPE OF ROCK? <br />CORRECT WIDTH? <br />OTHER <br />Y <br />Y <br />Y <br />Y <br />Y <br />Y <br />Y <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />MISCELLANEOUS: <br />DOES PERMIT DRAWING REFLECT ACCURATE LOCATION OF SYSTEM? <br />DOES PERMIT DRAWING SHOW SUFFICIENT DETAIL TO LOCATE IN FUTURE? <br />ANY NO ANSWER ABOVE REQUIRES PERMIT TO BE REDRAWN. <br />COMMENTS: <br />N <br />N <br />INSPECTED BY: h+5 v &End Iq w�Q..A) DATE: Il <br />��r� rs-1i7 <br />
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