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SR0079749
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4200/4300 - Liquid Waste/Water Well Permits
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SR0079749
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Last modified
4/24/2019 2:49:56 PM
Creation date
4/24/2019 2:27:02 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0079749
PE
4214
STREET_NUMBER
5120
Direction
E
STREET_NAME
LIVE OAK
STREET_TYPE
RD
City
LODI
Zip
95240
APN
05913012
ENTERED_DATE
10/17/2018 12:00:00 AM
SITE_LOCATION
5120 E LIVE OAK 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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e <br /> SEPTIC SYSTEM INSPECTION CHECK LIST <br /> ADDRESS: S Lt V o- PERMIT# 0 0 <br /> Check box ACTUAL MEETS SJC <br /> PARAMETER if inspected MEASUREMENT STANDARDS? CQMMENTS <br /> SEPTIC TANK: L <br /> CORRECT TANKCAPACIIY? Y N <br /> DISTANCE TO FOUNDATION? Y N <br /> DISTANCE TO PROPERTY LINE? Y N <br /> DISTANCETO ANY WELLS? Y N <br /> TANKLEVEL AND ORIENTED CORRECTLY? Y IN <br /> SANITARY TEES CORRECTLY INSTALLED? Y N t <br /> CORRECTTYPE OF PIPING? Y N <br /> TANK VENTED? Y N <br /> ANYTANKABNORMALIIIESNOTED? Y N <br /> OTHER Y N <br /> DISTRIBUTION BOX o _ J <br /> DISTANCE FROM TANK? Y N <br /> DISTANCE TO NEAREST LEACH LINE? Y N <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? Y N <br /> ISD-BOX LEVEL? Y N <br /> OTHER Y N L L r3c <br /> LEACHFIELD: (LL=LE4ACHLINES) _[� <br /> DISTANCE TO PROPERTY LINE? VU _ f Cy) N <br /> DISTANCE TO ANY WATER WELLS? g Q �} � N <br /> DISTANCE TO NEAREST FOUNDATION? N - <br /> DISTANCE OF SOIL BARRIER BETWEEN LPS? — Y N <br /> CORRECT DEPTH OF LLTRENCHES? Y N <br /> CORRECT DEPTH AND TYPE OF ROCK? _ Y N <br /> CORRECT WIDTH OF LL TRENCHES? a t_ Y N <br /> CORRECT LENGTH OF LL TRENCHES? ✓ go } k i N <br /> CORRECTTYPE OF PIPING? 5 35 N <br /> OTHER Y N <br /> SEEPAGE-PITS: '� <br /> DISTANCE TO PROPERTY LINE? �' �/ `f CYJ N <br /> DISTANCE TO ANY WATER WELLS? �/ S -{ Y N <br /> DISTANCE TO NEAREST FOUNDATION? (r N <br /> DISTANCE OF SOIL BARRIER TO PITO?Su vv STT N <br /> CORRECT DEPTH AND TYPE OF ROCK? �j -F 4 0 N <br /> CORRECTWIDTH? Y N <br /> OTHER Y N <br /> MISCELLANEOUS: <br /> DOES PERMIT DRAWING fREFLECTACCURATE LOCATION OF SYSTEM? Y No <br /> DOES PERMIT DRAWING SHOW SUFFICIENT DETAIL TO LOCATE IN FUTURE? (�Y N <br /> ANY NO ANSWER ABOVE REQUIRES PERMIT TO BE REDRAWN. (( © 1 <br /> COMMENTS: �I'o 1� w� Q ( I N o I I k� Vl O �l�H LSI^ ' 4 J <br /> x I <br /> INSPECTED BYrD DATE: <br />
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