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SR0078875
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4200/4300 - Liquid Waste/Water Well Permits
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SR0078875
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Entry Properties
Last modified
6/27/2018 2:04:32 PM
Creation date
4/19/2018 9:40:49 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0078875
PE
4219
FACILITY_NAME
GOLDSTONE LAND CO LLC
STREET_NUMBER
11900
Direction
N
STREET_NAME
FURRY
STREET_TYPE
RD
City
LODI
Zip
95240
APN
06116026
ENTERED_DATE
4/19/2018
SITE_LOCATION
11900 N FURRY RD
RECEIVED_DATE
3/16/2018
P_LOCATION
99
P_DISTRICT
004
Tags
EHD - Public
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SEPTIC SYSTEM INSPECTION CHECK LIST <br />ADDRESS: <br />PERMIT # <br />Check box ACTUAL <br />PARAMETER if inspected 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 />Y <br />Y <br />Y <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 />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 />`'f i <br />GJ 1 <br />yes <br />S <br />Y <br />g <br />Y <br />Y <br />Y <br />N f <br />N <br />N <br />N <br />N <br />x <br />x <br />'x <br />LEACH FIELD: ttftdE3j ir)fi <br />DISTANCE TO PROPERTY LINE? <br />DISTANCE TO ANY WATER WELLS? <br />DISTANCE TO NEAREST FOUNDATION? <br />DISTANCE OF SOIL BARRIER BETWEEN LUS? <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 />' o a (Y <br />d, -,k-Y <br />i Q IY <br />Y <br />a i Y <br />Y <br />Y <br />``tt Y <br />y e Cj Y <br />Y <br />N <br />N <br />N - <br />N <br />N <br />N <br />N <br />N <br />N STSR 35 <br />N <br />X <br />K <br />X�T <br />atm SUnrl� <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 />11 ll <br />K(v ( Ry <br />Q� <br />Y <br />01 <br />i - i�,! �� rQ(,,Y <br />1 Y <br />Y <br />N <br />N <br />N <br />N <br />N 1 •cJ �� Y�1� O1YOCA� S <br />N <br />N <br />yt <br />X <br />�( <br />j� <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: // Jn-� DATE: OAS, <br />I <br />
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