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SR0078560
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4200/4300 - Liquid Waste/Water Well Permits
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SR0078560
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Entry Properties
Last modified
6/27/2018 2:04:06 PM
Creation date
3/2/2018 8:54:55 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0078560
PE
4211
FACILITY_NAME
HOLLACE LASKEY
STREET_NUMBER
9597
STREET_NAME
KIRSCHENMAN
STREET_TYPE
RD
City
LODI
Zip
95240
APN
05111069
ENTERED_DATE
3/2/2018
SITE_LOCATION
9597 KIRSCHENMAN RD
RECEIVED_DATE
12/28/2017
P_LOCATION
99
P_DISTRICT
004
Tags
EHD - Public
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SEPTIC SYSTEM INSPECTION CHECK LIST <br />ADDRESS: u <br />PERMIT # Q <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 />/Zpd <br />/a/ <br />® <br />�f <br />® <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />-v/ <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 />V <br />7 <br />J <br />Lb <br />t'S t <br />© <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?L[p <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 />i <br />Z7i ® <br />2 <br />(�4 <br />�ur� <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />SEEPAGE PITS: <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 />f <br />(�`ID <br />'] 2 <br />In Ifi <br />12% <br />zst <br />'?for` <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 />(2) <br />N <br />N <br />INSPECTED BY/ <br />DATE: 77 <br />
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