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SR0078979
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0078979
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Entry Properties
Last modified
6/27/2018 2:04:39 PM
Creation date
5/7/2018 11:14:32 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0078979
PE
4210
FACILITY_NAME
MCAMIS, ROBERT L & HAENG S
STREET_NUMBER
1C039
STREET_NAME
JUNIPER
City
TRACY
Zip
95304
APN
80103039
ENTERED_DATE
5/7/2018
SITE_LOCATION
30000 KASSON RD 1C039 JUNIPER
RECEIVED_DATE
4/11/2018
P_LOCATION
99
P_DISTRICT
005
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SEPTIC SYSTEM[ INSPECTION GHECK LIST <br />INSPECTED BY: DATE: J' �� • � i <br />bs7 <br />ADD S: 30606 a.SS oA 0 3R PERMIT # -S <br />Check box ACTUAL MEETS SJC <br />PARAMETER If Inspected MEASUREMENT STANDARDS? CQMMENTS <br />74-#- <br />SEPTIC TANK: <br />CORRECT TANK CAPACITY? <br />TO FOUNDATION? <br />DISTANCE TO PROPERTY LINE? <br />DISTANCFTO ANY WELLS? <br />TANKLEVEL AND ORIENTED CORRECTLY? <br />SANITARY TEES CORRECTLY INSTALLED? <br />CORRECTTYPE OF PIPING? <br />TANK VENTED 7 <br />ANYTANKABNORMAUTIES NOTED? <br />OTHER <br />C/ Y N t �/1 <br />- N <br />Y <br />T{ ��' N <br />�_ N <br />Y N <br />Y N , <br />?� Y-- N <br />��� N <br />' N <br />r N <br />/%DISTANCE <br />DISTRIBUTION BOX: <br />DISTANCE FROM TANK? <br />DISTANCE TO NEAREST LEACH LINE? <br />DOES SYSTEM HAVE EQUAL DISTRIBUTION? <br />1S •D -BOX LEVEL? <br />OTHER <br />/ <br />V N <br />Y N vh Si <br />Y N <br />N <br />Y N <br />r <br />LEACH FIELD: (LL = L ES)' <br />DISTANCE TO PROPERTY LINE? L <br />DISTANCE TO ANY WATER WELLS? <br />DISTANGETONEAREST FOUNDATION?�/ <br />DISTANCE OF SOIL BARRIER BETWEEN LL'S? <br />CORRECT DEPTH OFLLTRENCHES? <br />CORRECT DEPTH AND TYPE OF ROCK? <br />CORRECTWIDTH OF LL TRENCHES? <br />CORRECT LENGTH OF LL TRENCHES? <br />CORRECTTYPE OF PIPING? <br />OTHER <br />_ Y N <br />YY N <br />rJ'% N <br />`-'� N <br />� /a,l/,Q(r'� N �I <br />�— N ;2 <br />N <br />+ Y\ N <br />— L% N <br />Y N <br />►1 <br />� <br />SEEPAGE PITS: <br />DISTANCE TO PROPERTY LINE? <br />DISTANCE TO ANY WATER WELLS? <br />DISTANCETONEAREST FOUNDATION? <br />DISTANCE OF SOIL BARRIER TO PITS? <br />CORRECT DEPTH AND TYPE 0 ? <br />CORRECTWIDTH? <br />OTHER <br />Y N <br />Y N <br />Y N <br />Y N <br />Y N <br />Y N <br />MISCELLANEOUS: <br />DOES PERMIT DRAWING REFLECT ACCURATE LOCATION OF SYSTEM? Y N <br />DOES PERMIT DRAWING SHOW SUFFICIENT DETAIL TO LOCATE IN FUTURE? Y N <br />ANY No ANSWER ABOVE UIRES PERMIT TO BE REDRAWN. <br />COMMENTS: ( ✓f� <br />�C/' J <br />akkk 4,q <br />Pi esin1� <br />w <br />,Ell 0 <br />jz5 D a <br />an1 Zi <br />ti oe <br />INSPECTED BY: DATE: J' �� • � i <br />bs7 <br />
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