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SR0078295
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0078295
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Entry Properties
Last modified
11/19/2024 3:48:03 PM
Creation date
3/5/2018 9:56:07 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0078295
PE
4211
FACILITY_NAME
JOSEPH REIFF
STREET_NUMBER
11124
Direction
E
STREET_NAME
STATE ROUTE 12
City
LOCKEFORD
Zip
95237
APN
05114055
ENTERED_DATE
3/5/2018
SITE_LOCATION
11124 E HWY 12
RECEIVED_DATE
10/23/2017
P_LOCATION
99
P_DISTRICT
004
Tags
EHD - Public
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SEPTIC SYSTEM INSPEGTION GHEGK LIST <br />INSPECTEDY: �I� ureic: <br />(� 2 �. 2 j PERMIT# S T�e� c! � g'Z�Checkbox <br />flADDRESS: <br />ACTUAL MEETSSJC <br />ARAMETER ifinspected MEASUREMENT STANDARDS? COMMENTS <br />EPTIC TANK: <br />CORREGTTANKCAPACITY? <br />DISTANCETO FOUNDATION? <br />DISTANCETO PROPERTY LINE? <br />DISTANGI=TO ANY WELLS? <br />TANKLEVELAND ORIENTED CORRECTLY? <br />SANITARYTEES CORRECTLY INSTALLED? <br />CORRECTTYPE OF PIPING? <br />TANK VENTED ? <br />ANYTANKABNORMALITIES NOTED? <br />OTHER <br />C, <br />`' �� Y N <br />N <br />N <br />N <br />Y' N <br />IN I S <br />Y N <br />N <br />�/ N <br />Y N <br />v <br />DISTRIBUTION 130)L <br />DISTANCE FROM TANK? <br />DISTANCETO NEAREST LEACH LINE? <br />DOES SYSTEM HAVE EQUAL DISTRIBUTION? <br />ISD -BOX LEVEL?11,12 <br />OTHER <br />C <br />Y N f <br />N <br />4 N <br />N <br />N <br />LEACH FIELD: (IL=LFACH ONES) <br />DISTANCE TO PROPERTY LINE? <br />DISTANCE TO ANY WATER WELLS? <br />DISTANCETO NEAREST FOUNDATION? <br />DISTANCE OF SOIL BARRIER BETWEEN LUS? <br />CORRECT DEPTH OF LLTRENGHES? <br />CORRECT DEPTH AND TYPE OF ROCK? <br />CORRECTWIDTH OF LL TRENCHES? <br />GORRECTLENGTHOFLLTRENCHES? <br />GORRECTTYPE OF PIPING? <br />OTHER <br />t ' <br />Y N <br />N <br />N <br />N <br />J--- :)d N <br />19 <br />�;, N <br />`], Y N <br />N <br />(` ? N <br />Y N <br />SEEPAGE PITS: <br />DISTANCE TO PROPERTY LINE? <br />DISTANCE TO ANY WATER WELLS? <br />DISTANCETO NEARESTFOUNDATION? <br />DISTANCE OFSOIL BARRIERTO PITS? <br />CORRECT DEPTH AND TYPE OF ROCK? <br />CORRECTWIDTH? <br />OTHER <br />n 1 <br />`] N <br />Ry, N <br />I Y N <br />` N <br />N <br />sy. N <br />Y N <br />Ni1SCELLANEOUS: <br />DOES PERMIT DRAWING REFLECT ACCURATE LOCATION OF SYSTEM? N <br />DOES PERMIT DRAWING SHOW SUFFICIENT DETAIL TO LOCATE IN FUTURE_? Y N <br />ANY NO ANSWER ABOVE REQUIRES PERMIT TO BE REDRAINN. <br />COMMENTS: <br />INSPECTEDY: �I� ureic: <br />
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