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SR0079042
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4200/4300 - Liquid Waste/Water Well Permits
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SR0079042
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Entry Properties
Last modified
6/27/2018 2:04:44 PM
Creation date
5/16/2018 4:48:10 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0079042
PE
4210
FACILITY_NAME
BOURBEAU, JOHN
STREET_NUMBER
16865
Direction
E
STREET_NAME
GAWNE
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
18309009
ENTERED_DATE
5/16/2018
SITE_LOCATION
16865 E GAWNE RD
RECEIVED_DATE
4/24/2018
P_LOCATION
99
P_DISTRICT
004
Tags
EHD - Public
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SEPTIC SYSTEM INSPECTION CHECK LIST <br />ADDRESS: (,► <br />*f <br />PERMIT# ,SALO 7e76W <br />Check box <br />PARAMETER if inspected <br />ACTUAL <br />MEASUREMENT <br />MEETS SJC <br />STANDARDS? COMMENTS <br />SEPTIC TANK: j(1 -b . <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 />E:d <br />DISTRIBUTION BOX: <br />DISTANCE FROM TANK?4 i <br />DISTANCE TO NEAREST LEACH LINE? <br />DOES SYSTEM HAVE EQUAL DISTRIBUTION? <br />IS D -BOX LEVEL? V7N <br />OTHER <br />CYC <br />10 <br />6% <br />Y <br />N <br />N <br />N <br />N <br />LEACH FIELD: (LL = LEACH LINES) <br />DISTANCE TO PROPERTY LINE? <br />DISTANCE TO ANY WATER WELLS? <br />DISTANCE TO NEAREST FOUNDATION? <br />DISTANCE OF SOIL BARRIER BETWEEN LL'S? <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 />b 69 <br />Y <br />off <br />�4 � <br />2 � <br />om 1 <br />-`� Y <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />v <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 />CORRECT WIDTH? <br />OTHER <br />_ <br />66 I <br />7 <br />'i ^l l.i— <br />! <br />Z S—� <br />Y <br />N <br />N <br />N <br />N <br />N <br />N <br />N <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: � J�e/J� <br />DATE: <br />DATE: <br />
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