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SR0074664
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0074664
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Last modified
7/19/2018 9:53:05 AM
Creation date
7/18/2018 2:31:26 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0074664
PE
4231
FACILITY_NAME
CHEROKEE MEMORIAL PARK INC
STREET_NUMBER
14165
Direction
N
STREET_NAME
BECKMAN
STREET_TYPE
RD
City
LODI
Zip
95242
APN
06103067
ENTERED_DATE
7/18/2018
SITE_LOCATION
14165 N BECKMAN RD
RECEIVED_DATE
4/15/2016
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Tags
EHD - Public
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SEPTIC SYSTEM INSPECTION CHECK LIST <br />ADDRESS: <br />,�,� <br />PERMIT # S <br />Check box <br />ACTUAL <br />MEETS SJC <br />PARAMETER if inspected <br />MEASUREMENT <br />STANDARDS? COMMENTS <br />SEPTIC TANK: <br />CORRECT TANK CAPACITY? <br />%G`L <br />N <br />DISTANCE TO FOUNDATION? <br />lDzf <br />N <br />DISTANCE TO PROPERTY LINE? <br />,GZ ` <br />N <br />✓ <br />DISTANCE TO ANY WELLS? <br />_ <br />> LoOv <br />N <br />►/ <br />TANK LEVEL AND ORIENTED CORRECTLY? <br />Y <br />N <br />SANITARY TEES CORRECTLY INSTALLED? <br />® <br />N , <br />1/ <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 />DISTRIBUTION BOX: <br />DISTANCE FROM TANK? <br />✓ <br />Y <br />N <br />DISTANCE TO NEAREST LEACH LINE? <br />✓ <br />�'' <br />N <br />DOES SYSTEM HAVE EQUAL DISTRIBUTION? <br />N <br />IS D -BOX LEVEL? <br />N <br />OTHER <br />Y <br />N <br />LEACH FIELD: (LL=LEACH LINES) <br />DISTANCE TO PROPERTY LINE? <br />N <br />DISTANCE TO ANY WATER WELLS? <br />> !Q>D' <br />N <br />DISTANCE TO NEAREST FOUNDATION? <br />N <br />DISTANCE OF SOIL BARRIER BETWEEN LL'S? <br />N <br />CORRECT DEPTH OF LL TRENCHES? <br />✓ <br />3e, �� <br />C� <br />N <br />CORRECT DEPTH AND TYPE OF ROCK? <br />✓ <br />2'1l <br />N <br />CORRECT WIDTH OF LL TRENCHES? <br />CORRECT LENGTH OF LL TRENCHES? <br />✓ <br />V <br />3'S <br />N <br />N <br />CORRECT TYPE OF PIPING? <br />%�'� <br />(y <br />N <br />OTHER <br />Y <br />N <br />SEEPAGE PITS: <br />DISTANCE TO PROPERTY LINE? <br />Y <br />N <br />DISTANCE TO ANY WATER WELLS? <br />Y <br />N <br />DISTANCE TO NEAREST FOUNDATION? <br />Y <br />N <br />DISTANCE OF SOIL BARRIER TO PITS? <br />Y <br />N <br />CORRECT DEPTH AND TYPE OF ROCK? <br />Y <br />N <br />CORRECT WIDTH? <br />Y <br />N <br />OTHER <br />Y <br />N <br />MISCELLANEOUS: <br />DOES PERMIT DRAWING REFLECT ACCURATE LOCATION OF <br />SYSTEM? <br />Y <br />N <br />DOES PERMIT DRAWING SHOW SUFFICIENT DETAIL <br />TO LOCATE IN FUTURE? <br />Y <br />N <br />ANY NO ANSWER ABOVE REQUIRES PERMIT TO <br />BE REDRAWN. <br />COMMENTS: <br />INSPECTEDBY:L """' - <br />
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