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SR0080178
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4200/4300 - Liquid Waste/Water Well Permits
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SR0080178
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Last modified
4/24/2019 3:52:11 PM
Creation date
4/24/2019 2:36:12 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0080178
PE
4210
STREET_NUMBER
22909
Direction
N
STREET_NAME
BENDER
STREET_TYPE
RD
City
ACAMPO
Zip
95220
APN
00317059
ENTERED_DATE
2/6/2019 12:00:00 AM
SITE_LOCATION
22909 N BENDER 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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SEPTIC SYSTEM!( INSPECTION CHECK LIST <br /> ADDRESS: ,/,k f L PERMIT# S O C f <br /> Checkbox ACTUAL MEETSSJC <br /> PARAMETER if inspected MEASUREMENT STANDARDS? CQMMENTS <br /> SEPTIC TANK: �7 <br /> CORRECT TANK CAPAAITY? 12-0 0 N <br /> DISTANCE TO FOUNDATION? V _� Y N <br /> DISTANCETOPROPERTYLINE? Ej 1 Y N <br /> DISTANCE TO ANY WENS? V N <br /> TANK LEVEL AND ORIENTED CORRECTLY? IN <br /> SANITARY TEES CORRECTLY INSTALLED? `/ Y N <br /> CORRECT TYPE OF PIPING? S �_ N <br /> TANK VENTED? N <br /> ANY TANK ABNORMALITIES NOTED? Y N <br /> OTHER Y N <br /> DISTRIBUTION BOX: � ( <br /> DISTANCE FROM TANK? (� S t—f Y N r <br /> DISTANCE TO NEAREST LEACFILINE? �/ N <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? �/ N <br /> ISD-BOX LEVFL7 Y N <br /> OTHER Y N <br /> LEACH FIELD: (LL=LEACH LINES) ri,14'r— <br /> DISTANCE TO PROPERTY LINE? Y N <br /> DISTANCE TO ANY WATER WELLS? Jl Y N <br /> DISTANCETO NEAREST FOUNDATION? N - <br /> DISTANCE OF SOIL BARRIER BETWEEN 1.12S? Y N <br /> CORRECT DEPTH OF LLTRENCHES? L/ Q n N <br /> CORRECT DEPTH AND TYPE OF ROCK? vi N r Yl <br /> CORRECT WIDTH OF LL TRENCHES? .� 2 C47 N 542 <br /> CORRECT LENGTH OF LL TRENCHES? N <br /> CORRECT TYPE OF PIPING? �_ S S U' N <br /> OTHER z Y N <br /> SEEPAGE PITS: <br /> DISTANCE TO PROPERTY LINE? \ Y N <br /> DISTANCE TO ANY WA17ER 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 /> CORRECTWIDTH? Y N <br /> OTHER Y N <br /> MISCELLANEOUS: <br /> DOES PERMIT DRAWING REFLECTACCURATE LOCATION OF SYSTEM? <br /> DOES PERMIT DRAWING SHOW SUFFICIENT DEI-AIL TO LOCATE IN FUTURE? Y <br /> ANY NO ANSWER ABOVE REQUIRES PERMITTn RF REDRAWN. <br /> COMMENTS: <br /> INSPECTED 13Y:- <br /> Jr, ,/, _ DAIS / 7 I <br /> �Y r�? <br />
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