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SR0080200
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0080200
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Last modified
4/12/2019 10:25:10 AM
Creation date
4/12/2019 9:43:52 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0080200
PE
4210
STREET_NUMBER
21025
Direction
S
STREET_NAME
JACK TONE
STREET_TYPE
RD
City
RIPON
Zip
95366
APN
22811001
ENTERED_DATE
2/11/2019 12:00:00 AM
SITE_LOCATION
21025 S JACK TONE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
DAfonskaia
Tags
EHD - Public
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SEPTIC SYSTEM INSPECTION CHECK LIST <br /> ADDRESS: Z16Z S. jeteg Jont PERMIT# Sgoo OZOa <br /> Check box ACTUAL MEETS SJC <br /> PARAMETER if inspected MEASUREMENT STANDARDS? COMMENTS <br /> SEPTIC TANK: <br /> CORRECT TANK CAPACITY? 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 Y N <br /> DISTRIBUTION BOX: <br /> DISTANCE FROM TANK? Zy y'' <br /> N <br /> DISTANCE TO NEAREST LEACH LINE? �/ —�2'� ® N <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? y N <br /> IS D-BOX LEVEL? N <br /> OTHER Y N <br /> LEACH FIELD: (LL=LEACH LINES) <br /> DISTANCE TO PROPERTY LINE? dv 11) N <br /> DISTANCE TO ANY WATER WELLS? iyy ZD N <br /> DISTANCE TO NEAREST FOUNDATION? 6) N <br /> DISTANCE OF SOIL BARRIER BETWEEN LL'S? —�� Y N <br /> CORRECT DEPTH OF LL TRENCHES? Z) N <br /> CORRECT DEPTH AND T);PE OF ROCK? �? -h•4y(D1S a� N <br /> CORRECT WIDTH OF le`/TRENCHES? Z/ c0 N <br /> CORRECT LENGTH OF LL TRENCHES? l j► 40' N <br /> CORRECT TYPE OF PIPING? 00 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? N <br /> DOES PERMIT DRAWING SHOW SUFFICIENT DETAIL TO LOCATE IN FUTURE? 4' N <br /> ANY NO ANSWER ABOVE REQUIRES PERMIT TO BE REDRAWN, <br /> COMMENTS: <br /> INSPECTED BY: X'09 H_- 14,K69 DATE: <br />
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