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SR0079483
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0079483
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Entry Properties
Last modified
9/12/2018 12:11:02 PM
Creation date
9/12/2018 12:08:42 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0079483
PE
4211
STREET_NUMBER
8669
Direction
W
STREET_NAME
ETCHEVERRY
STREET_TYPE
DR
City
TRACY
Zip
95304
APN
24812007
ENTERED_DATE
8/7/2018 12:00:00 AM
SITE_LOCATION
8669 W ETCHEVERRY DR
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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DAfonskaia
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EHD - Public
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SEPTIC SYSTEM INSPECTION CHECK LIST <br />ADDRESS: (1-9 <br />w�wPERMIT <br />Check box ACTUAL <br />PARAMETER if inspected MEASUREMENT <br />MEETS SJC <br />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 />TANK VENTED ? <br />ANY TANK ABNORMALITIES NOTED? <br />OTHER <br />j Q <br />14-13 Gy-) <br />� Y <br />Y <br />�/Gi c,' Y <br />yZC> <br />Q <br />S <br />—� G Y <br />Y <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />i / <br />r/ <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 />7rlZ 1eV_e,lj_ <br />y ZS <br />G) <br />G) <br />0� <br />l ' / <br />Y <br />N <br />N <br />N <br />N <br />N <br />r,/ <br />4% <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 LL TRENCHES? <br />CORRECT TYPE OF PIPING? <br />OTHER <br />SY <br />&'A <br />G� Y <br />Y <br />/ <br />C C OY <br />J 171 - <br />Y <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />�,/ <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 />OTHER <br />�,/ <br />;,/ <br />/ <br />Y ) <br />�. Y <br />r Y <br />1 o I Y <br />1� Y <br />Y <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />6, <br />MISCELLANEOUS: <br />DOES PERMIT DRAWING REFLECT ACCURATE LOCATION OF SYSTEM? <br />DOES PERMIT DRAWING SHOW SUFFICIENT DETAIL TO LOCATE IN FUTURE? Fy <br />ANY NO ANSWER ABOVE REQUIRES PERMIT TO BE REDRAWN. <br />COMMENTS: <br />N <br />N <br />INSPECTED BY: Li �� � <br />(C�CNY1 � �� <br />DATE: <br />
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