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SR0080040
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4200/4300 - Liquid Waste/Water Well Permits
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SR0080040
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Last modified
4/11/2019 12:21:17 PM
Creation date
4/11/2019 12:10:55 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0080040
PE
4215
STREET_NUMBER
23896
Direction
S
STREET_NAME
SANTA FE
STREET_TYPE
RD
City
RIVERBANK
Zip
95367
APN
24907008
ENTERED_DATE
1/3/2019 12:00:00 AM
SITE_LOCATION
23896 S SANTA FE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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SEPTIC SYSTEM INSPECTION CHECK LIST <br /> ADDRESS: 2,3 S•%G S 54,, 1.e PERMIT# &,oZe-e <br /> Check box ACTUAL MEETS SJC <br /> PARAMETER if inspected MEASUREMENT STANDARDS? COMMENTS <br /> SEPTIC TANK: &.mi.+, <br /> CORRECT TANK CAPACITY? a Y N <br /> DISTANCE TO FOUNDATION? Y N <br /> DISTANCE TO PROPERTY LINE? Y N <br /> DISTANCE TO ANY WELLS? Y N <br /> TANK LEVEL AND ORIENTED CORRECTLY? Y N <br /> SANITARY TEES CORRECTLY INSTALLED? Y N <br /> CORRECT TYPE OF PIPING? Y N <br /> TANK VENTED? Y N <br /> ANY TANK ABNORMALITIES NOTED? Y N <br /> OTHER Ed Y N <br /> DISTRIBUTION BOX: / <br /> DISTANCE FROM TANK? r <br /> Sr C? N S« �lAb..1.-.yam <br /> DISTANCE TO NEAREST LEACH LINE? S ' 'Z) N <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? 4� N <br /> IS D-BOX LEVEL? 47 N <br /> OTHER Y N <br /> LEACH FIELD: (LL=LEACH LINES) <br /> DISTANCE TO PROPERTY LINE? 9B N <br /> DISTANCE TO ANY WATER WELLS? 113' 4> N <br /> DISTANCE TO NEAREST FOUNDATION? / 7 ' 4) N <br /> DISTANCE OF SOIL BARRIER BETWEEN LL'S? Y N <br /> CORRECT DEPTH OF LL TRENCHES? �l3' N <br /> CORRECT DEPTH AND TYPE OF ROCK? QP N <br /> CORRECT WIDTH OF LL TRENCHES? Z tP N <br /> CORRECT LENGTH OF LL TRENCHES? N <br /> CORRECT TYPE OF PIPING? �1�/23S Zfl 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? YN <br /> OTHER Y N <br /> MISCELLANEOUS: <br /> DOES PERMIT DRAWING REFLECT ACCURATE LOCATION OF SYSTEM? 47 N <br /> DOES PERMIT DRAWING SHOW SUFFICIENT DETAIL TO LOCATE IN FUTURE? ® N <br /> ANY NO ANSWER ABOVE REQUIRES PERMIT TO BE REDRAWN. <br /> COMMENTS: <br /> INSPECTED BY: /f'`f1rSL�Eii , 7�rj/��o DATE: <br />
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