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SR0078835
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4200/4300 - Liquid Waste/Water Well Permits
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SR0078835
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Last modified
6/27/2018 2:04:31 PM
Creation date
3/19/2018 3:12:46 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0078835
PE
4210
FACILITY_NAME
VOSE, DOUGLAS & LYNETTE
STREET_NUMBER
22756
Direction
N
STREET_NAME
PELTIER
STREET_TYPE
CT
City
ACAMPO
Zip
95220
APN
00735008
ENTERED_DATE
3/19/2018
SITE_LOCATION
22756 N PELTIER CT
RECEIVED_DATE
3/8/2018
P_LOCATION
99
P_DISTRICT
004
Tags
EHD - Public
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SEPTIC SYSTEM INSPECTION CHECK LIST <br />INSPECTED BY: DAT/�� f� <br />ADDRESS: 1 PERMIT # 53 <br />Check box ACTUAL MEETS SJC <br />PARAMETER If Inspected MEASUREMENT STANDARDS? CQMMENTS <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 CORREC ? <br />SANITARY TEES CORRECTLY INSTALLED? <br />CORRECTTYPE OF PIPING? <br />TANKVENTED ? <br />ANYTANKABNORM NOTED? <br />OTHER <br />Y N <br />Y <br />N <br />Y N <br />Y N <br />N <br />N <br />Y N <br />DISTRIBUTION BOX <br />DISTANCE FROM TANK? <br />DISTANCE TO NEAREST LEACH LINE? <br />DOES SYSTEM HAVE EQUAL DISTRIBUTION? <br />ISD -BOX LEVEL? <br />OTHER <br />, <br />N 6 Zi -N f <br />r Y N <br />N <br />(' N <br />Y N <br />LEACH FIELD: (LL= LES CH LINES) <br />DISTANCE TO PROPERTY LINE? <br />DISTANCE TO ANY WATER KNELLS? <br />DISTANCETONEAREST FOUNDATION? <br />DISTANCE OF SOIL BARRIER BETWEEN L1287 <br />CORRECT DEPTH OFLLTRENCHES? <br />CORRECT DEPTH AND TYPE OF ROCK? <br />CORRECT WIDTH OF LL TRENCHES? <br />CORRECT LENGTH OF LL TRENCHES? <br />CORRECTTYPE OF PIPING? <br />OTHER <br />' <br />Y N <br />Y N <br />N - <br />�J —6 _ N <br />�" N <br />-� I c N <br />N <br />' Y N <br />N <br />Y 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 />CORRECTWIDTH? <br />OTHER <br />a <br />'/') . Yl N <br />Y N <br />Y N <br />N <br />" Y' N <br />Y N <br />MISCELLANEOUS: <br />DOES PERMIT DRAWING REFLECTACCURATE LOCATION OF SYSTEM? Y N <br />DOES PERMIT DRAWING SHOW SUFFICIENT DETAIL TO LOCATE IN FUTURE? Y N <br />ANY NO ANSWER ABOVE REQUIRES PERMIT TO BE REDRAWN. <br />COMMENTS: <br />L4 G <br />INSPECTED BY: DAT/�� f� <br />
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