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SR0078344
EnvironmentalHealth
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99 (STATE ROUTE 99)
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4200/4300 - Liquid Waste/Water Well Permits
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SR0078344
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Entry Properties
Last modified
11/19/2024 1:58:34 PM
Creation date
3/2/2018 11:36:15 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0078344
PE
4210
FACILITY_NAME
JENNIFER WALLACE TR
STREET_NUMBER
11786
Direction
N
STREET_NAME
STATE ROUTE 99
City
LODI
Zip
95240
APN
06109040
ENTERED_DATE
3/2/2018
SITE_LOCATION
11786 N HWY 99
RECEIVED_DATE
11/1/2017
P_LOCATION
99
P_DISTRICT
004
Tags
EHD - Public
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z <br />SEPTIC SYSTEM INSPECTION GHEGK LIST <br />ADDRESS: & -,I-j y PERMIT # S 4Z <br />Check b6 ACTUAL MEEFSSJG <br />PARAMETER if inspected MFASUREMENT STANDARDS? GQINMENTS <br />SEPTIC TANK: <br />CORRECT TANKCAPANTY? <br />DISTANCETO FOUNDATION? <br />DISTANCE TO PROPERTY LINE? <br />DISTANCHTO ANY WELLS? <br />TANKLEVEL AND ORIENTED CORRECTLY? <br />SANITARYTEES CORRECTLY INSTALLED? <br />CORRECTTYPE OF PIPING? <br />TANKVENTED? <br />ANYTANKABNORMALITIES NOTED? <br />OTHER <br />Y N <br />Y N <br />Y N <br />Y N <br />Y N <br />Y N , <br />Y N <br />Y N <br />Y N_ <br />Y N <br />DISTRIBUTION BOX: <br />DISTANCE FROM TANK? <br />DISTANCETO NEAREST LEACH LINE? <br />DOES SYSTEM HAVE EQUAL DISTRIBUTION? <br />1S-D-BOXLEVEL? <br />OTHER <br />Y N <br />Y N <br />Y N. <br />\ Y N <br />Y N <br />LEA GH FIELD: (LL=LEACH LINES) OA <br />DISTANCE TO PROPERTY LINE? <br />DISTANCE TO ANY WATER WE -LS? <br />DISTANCETO NEARESTFOUNDAT i0N? <br />DISTANCE OF SOIL BARRIER BETWEEN L US? <br />CORRECT DEPTH OFLLTRENGHES? <br />CORRECT DEPTH AND TYPE OF ROCK? <br />CORRECTWIDTHOFLLTRENGHES? <br />CORRECT LENGTH OF LL TRENCHES? <br />CORRECTTYPE OF PIPING? <br />OTHER <br />Y N <br />Y N <br />Y N - <br />Y N <br />Y N <br />• S olC7l iA Cro N <br />[ Y N <br />i N <br />N <br />N <br />✓ <br />L/ <br />SEEPAGE PITS: <br />DISTANCE TO PROPERTY LINE? <br />DISTANCE To ANY WATER WELLS? <br />DISTANCETO NEAREST FOUNDATION? <br />DISTANCE OF SOIL BARRIER TO PITS? <br />GORRECTDEPTH AND TYPE OF ROCK? <br />GORRECTWIDTH? <br />OTHER <br />� <br />Z� Iii N <br />Y N <br />N <br />N <br />Y N <br />(P N <br />Y N <br />✓ <br />MISCELLANEOUS: <br />DOES PERMIT DRAINING REFLECTACCURATE LOCATION OF SYSTEM? Y N <br />DOES PERMITDRAWING SHOW SUFFICIENT DETAILTO LOCATE IN FUTURE? Y N <br />ANYNOANSWERABOVEREQUIRESaTTOBEREDRAWN. <br />COMMENTS: <br />INSPECTED BY: � Qf DATE: <br />
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