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SR0079091
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4200/4300 - Liquid Waste/Water Well Permits
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SR0079091
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Last modified
7/19/2018 9:58:51 AM
Creation date
7/18/2018 3:21:10 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0079091
PE
4210
FACILITY_NAME
ADKINS, JAMES T & MELINDA J TR
STREET_NUMBER
31243
Direction
S
STREET_NAME
KASSON
STREET_TYPE
RD
City
TRACY
Zip
95304
APN
25523013
ENTERED_DATE
7/18/2018
SITE_LOCATION
31243 S KASSON RD
RECEIVED_DATE
5/9/2018
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Tags
EHD - Public
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SEPTIC SYSTEM INSPECTION GHECK LIST <br />INSPECTED BY: U � ,_j\ DATE: • 0 / L/ \ . \ I �/ <br />P-- �U J <br />ADDRESS: 3 `-� S• s S dY� PERMIT <br />Check box ACTUAL MEETS SJC <br />PARAMETER ifinspected MEASUREMENT STANDARDS? CQMMENTS <br />SEPTIC TANK: <br />CORRECT TANK CAPACITY?N <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 />TANKVENTED ? <br />ANY TANK ABNORMALITIES NOTED? <br />OTHER <br />4Zo 69 <br />�; N <br />ti N <br />�v�� YN <br />N��� /1 <br />Y N <br />N <br />�� N _ <br />Y N _ <br />Y N <br />DISTRIBUTION BOX: <br />DISTANCE FROM TANK? <br />DISTANCE TO NEARESTLEACH LINE? <br />DOES SYS CEM HAVE EQUAL DISTRIBUTION? <br />IS -D-BOX LEVEL? <br />OTHER <br />Y N t <br />Y N <br />Y N <br />Y N <br />Y 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 OFtLTRENCHES? <br />CORRECT LENGTH OFLLTRENCHES? <br />CORRECT TYPE OF PIPING? <br />OTHER <br />Y N <br />Y N <br />Y N T <br />Y N <br />Y N <br />Y N <br />Y N <br />Y N <br />Y N <br />Y N <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 />CORRECTWIDTH? <br />OTHER <br />Y N <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 A OVE RE IRES PERMIT TO BE qEDRAVVN. f' <br />COMMEhCCS_ <br />INSPECTED BY: U � ,_j\ DATE: • 0 / L/ \ . \ I �/ <br />P-- �U J <br />
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