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SR0079323
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0079323
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Entry Properties
Last modified
9/12/2018 9:31:42 AM
Creation date
9/12/2018 9:23:05 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0079323
PE
4215
STREET_NUMBER
1010
Direction
N
STREET_NAME
SHAW
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
14327062
ENTERED_DATE
6/25/2018 12:00:00 AM
SITE_LOCATION
1010 N SHAW RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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DAfonskaia
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EHD - Public
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SEPTIC SYSTEM INSPECTION CHECK LIST <br />INSPECTED BY: I r DATE: <br />/�O'l <br />ADDRESS: PERMIT # 6e <br />Check box ACTUAL MEETSSJC" <br />PARAMETER If inspected MEASUREMENT STANDARDS? COMMENTS <br />SEPTIC TANK: <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 />TANKVENTED? <br />ANY TANK ABNORMALITIES <br />OTiftR <br />Y N <br />Y N <br />Y N <br />N <br />Y N <br />Y N <br />Y N <br />Y N <br />Y N <br />T Sp 'r— Y N ; q <br />- <br />DISTRIBUTION BOX: <br />DISTANCE FROM TANK? <br />DISTANCE TO NEAREST LEACH LINE? <br />DOES SYSTEM HAVE EQUAL DISTRIBUTION? <br />IS D -BOX LEVEL? <br />OTHER <br />1 <br />� Y N <br />Gam— N <br />N <br />, 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 LUS? <br />CORRECT DEPTH OF LL TRENCHES? <br />CORRECT DEPTH AND TYPE OF ROCK? <br />CORRECT WIDTH OF LL TRENCHES? <br />CORRECT LENGTH OF H TRENCHES? <br />CORRECT TYPE OF PIPING? <br />OTHER <br />e, c <br />) N <br />Y N <br />Z% N - <br />7 Y N <br />N <br />` Y N <br />21 N <br />54N <br />S Y N <br />.o— <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 />CORRECT WIDTH? <br />OTHER <br />r N <br />Y N <br />Z Y N <br />1 N <br />-26 N <br />(.� " Y N <br />Y N <br />.� <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 REQUIRES PERMIT TO BE REDRAWN. <br />COMMENTS: <br />A A <br />INSPECTED BY: I r DATE: <br />/�O'l <br />
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