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SR0079771
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4200/4300 - Liquid Waste/Water Well Permits
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SR0079771
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Last modified
4/11/2019 12:18:11 PM
Creation date
4/11/2019 12:07:49 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0079771
PE
4214
FACILITY_NAME
30000 KASSAN 2B053 SYCAMORE RD
STREET_NUMBER
30000
STREET_NAME
KASSON
STREET_TYPE
RD
City
TRACY
Zip
95304
APN
80202053
ENTERED_DATE
10/22/2018 12:00:00 AM
SITE_LOCATION
30000 KASSON RD 65
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: Z PERMIT# <br /> 7#/-- Check box ACTUAL MEETS SJC <br /> PARAMETER if inspected MEASUREMENT STANDARDS? COMMENTS <br /> SEPTIC TANK: <br /> CORRECT TANK CAPACITY? N <br /> DISTANCE TO FOUNDATION? 4D N <br /> DISTANCE TO PROPERTY LINE? 7 4!V N <br /> DISTANCE TO ANY WELLS? ��Klf Y N <br /> TANK LEVEL AND ORIENTED CORRECTLY? r N <br /> SANITARY TEES CORRECTLY INSTALLED? N <br /> CORRECT TYPE OF PIPING? N <br /> TANK VENTED? Cr N <br /> ANY TANK ABNORMALITIES NOTED? Qb N <br /> OTHER Y N <br /> DISTRIBUTION BOX: <br /> DISTANCE FROM TANK? <br /> DISTANCE TO NEAREST LEACH LINE? �! 2� N <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? 4 N <br /> IS D-BOX LEVEL? 0 N <br /> OTHER Y N <br /> LEACH FIELD: <br /> DISTANCE TO PROP TY LINE? 7 2'X N <br /> DISTANCE TO ANY WATER WELLS? N <br /> DISTANCE TO NEAREST FOUNDATION? N <br /> DISTANCE OF SOIL BARRIER BETWEEN LL'S? Y N <br /> CORRECT DEPTH OF LL TRENCHES? �%2 f Cp N <br /> CORRECT DEPTH AND TYPE OF ROCK? Y N <br /> CORRECT WIDTH OF LL TRENCHES? /3' N <br /> CORRECT LENGTH OF LL TRENCHES? ,�j'' a N <br /> CORRECT TYPE OF PIPING? � y/1 jj 0 N <br /> OTHER Y N <br /> SEEPAGE PITS: <br /> DISTANCE TO PROPERTY LINE? Y N <br /> DISTANCE TO ANY WATER WELLS? Y N <br /> DISTANCE TO NEAREST FOUNDATION? Y N <br /> DISTANCE OF SOIL BARRIER TO PITS? Y N <br /> CORRECT DEPTH AND TYPE OF ROCK? Y N <br /> CORRECT WIDTH? Y N <br /> OTHER Y N <br /> MISCELLANEOUS: <br /> DOES PERMIT DRAWING REFLECT ACCURATE LOCATION OF SYSTEM? !r' N <br /> DOES PERMIT DRAWING SHOW SUFFICIENT DETAIL TO LOCATE IN FUTURE? O N <br /> ANY NO ANSWER ABOVE REQUIRES PERMIT TO BE REDRAWN. <br /> COMMENTS: <br /> INSPECTED BY: �«,11-- DATE: <br />
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