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SR0079043
EnvironmentalHealth
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ESCALON BELLOTA
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4200/4300 - Liquid Waste/Water Well Permits
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SR0079043
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Entry Properties
Last modified
6/27/2018 2:04:44 PM
Creation date
5/16/2018 4:50:49 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0079043
PE
4210
FACILITY_NAME
HAGAN INVESTMENTS LLC ETAL
STREET_NUMBER
17005
Direction
S
STREET_NAME
ESCALON BELLOTA
STREET_TYPE
RD
City
ESCALON
Zip
95320
APN
22502010
ENTERED_DATE
5/16/2018
SITE_LOCATION
17005 S ESCALON BELLOTA RD
RECEIVED_DATE
4/28/2018
P_LOCATION
99
P_DISTRICT
004
Tags
EHD - Public
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SEPTIC SYSTEM INSPECTION CHECK LIST <br />ADDRESS: j ESQ �,,y13eZLIO <br />'c 122W <br />PERMIT# <br />Check box <br />ACTUAL <br />MEETS SJC <br />PARAMETER if inspected <br />MEASUREMENT <br />STANDARDS? <br />COMMENTS <br />SEPTIC TANK: Ib N <br />CORRECT TANK CAPACITY? <br />Y <br />N <br />DISTANCE TO FOUNDATION? <br />Y <br />N <br />DISTANCE TO PROPERTY LINE? <br />Y <br />N <br />DISTANCE TO ANY WELLS? <br />Y <br />N <br />TANK LEVEL AND ORIENTED CORRECTLY? <br />Y <br />N <br />SANITARY TEES CORRECTLY INSTALLED? <br />Y <br />N <br />CORRECT TYPE OF PIPING? <br />Y <br />N <br />TANK VENTED ? <br />Y <br />N <br />ANY TANK ABNORMALITIES NOTED? <br />Y <br />N <br />OTHER <br />Y <br />N <br />Ed <br />DISTRIBUTION BOX: — i a ,�WIL . <br />DISTANCE FROM TANK? <br />Y <br />N <br />DISTANCE TO NEAREST LEACH LINE? <br />Y <br />N <br />DOES SYSTEM HAVE EQUAL DISTRIBUTION? <br />Y <br />N <br />IS D -BOX LEVEL? <br />Y <br />N <br />OTHER <br />Y <br />N <br />LEACH FIELD: (LL = LEACH LINES) <br />DISTANCE TO PROPERTY LINE? <br />�ry <br />DISTANCE TO ANY WATER WELLS? <br />y�, r <br />N <br />DISTANCE TO NEAREST FOUNDATION? <br />f '] <br />N <br />DISTANCE OF SOIL BARRIER BETWEEN LL'S? <br />��- <br />Y <br />N <br />CORRECT DEPTH OF LL TRENCHES? <br />yam►/ 3 �' <br />N <br />CORRECT DEPTH AND TYPE OF ROCK? <br />00, <br />N <br />CORRECT WIDTH OF LL TRENCHES? <br />y <br />Z 1 <br />N <br />CORRECT LENGTH OF LL TRENCHES? <br />N <br />CORRECT TYPE OF PIPING?rj�j►2 <br />7� <br />$i <br />N <br />OTHER <br />Y <br />N <br />SEEPAGE PITS: <br />DISTANCE TO PROPERTY LINE? <br />N <br />DISTANCE TO ANY WATER WELLS? <br />N <br />DISTANCE TO NEAREST FOUNDATION? <br />of <br />/ f- <br />N <br />DISTANCE OF SOIL BARRIER TO PITS? <br />N <br />CORRECT DEPTH AND TYPE OF ROCK? <br />i 1 <br />N <br />CORRECT WIDTH? Ll <br />(J �f <br />N <br />OTHER <br />Y <br />N <br />MISCELLANEOUS: <br />DOES PERMIT DRAWING REFLECT ACCURATE LOCATION OF SYSTEM? <br />N <br />DOES PERMIT DRAWING SHOW SUFFICIENT DETAIL TO LOCATE IN FUTURE? <br />® <br />N <br />ANY NO ANSWER ABOVE REQUIRES PERMIT TO BE REDRAWN. <br />COMMENTS: <br />INSPECTED BY: <br />DATE: <br />
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