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SR0080378
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4200/4300 - Liquid Waste/Water Well Permits
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SR0080378
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Last modified
4/24/2019 3:57:16 PM
Creation date
4/24/2019 2:39:09 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0080378
PE
4210
STREET_NUMBER
26142
Direction
N
STREET_NAME
BLOSSOM
STREET_TYPE
RD
City
THORNTON
Zip
95686
APN
00115001
ENTERED_DATE
3/27/2019 12:00:00 AM
SITE_LOCATION
26142 N BLOSSOM 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: uS PERMIT# rj f2 fj`G " <br /> Check box ACTUAL MEETS SJC <br /> PARAMETER if inspected MEASUREMENT STANDARDS? COMMENTS <br /> SEPTIC TANK: <br /> CORRECT TANK CAPACITY?��t 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? ✓ N <br /> CORRECT TYPE OF PIPING? % N <br /> TANK VENTED? Y N <br /> ANY TANK ABNORMALITIES NOTED? Y N <br /> OTHER Y N <br /> DISTRIBUTION BOX: <br /> DISTANCE FROM TANK? ✓ l 3 N <br /> DISTANCE TO NEAREST LEACH LINE? ✓ S t N <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? ✓ rY N <br /> IS D-BOX LEVEL? `(�\ N <br /> OTHER Y N <br /> LEACH FIELD: (LL=LEACH LINES) r � '�'l <br /> DISTANCE TO PROPERTY LINE? ✓ + (T/ N <br /> DISTANCE TO ANY WATER WELLS? F f� {( 1?j� O N <br /> DISTANCE TO NEAREST FOUNDATION? v } Y N <br /> DISTANCE OF SOIL BARRIER BETWEEN LL'S? ,/ (e ( E + Z O N <br /> CORRECT DEPTH OF LL TRENCHES? r N <br /> CORRECT DEPTH AND TYPE OF ROCK? 14 N <br /> CORRECT WIDTH OF LL TRENCHES? 2 iLA N <br /> CORRECT LENGTH OF LL TRENCHES? ✓ N <br /> CORRECT TYPE OF PIPING? ALr rt`P ar— N <br /> OTHER Y N <br /> SEEPAGE PITS: n <br /> DISTANCE TO PROPERTY LINE? r V 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? Y <br /> DOES PERMIT DRAWING SHOW SUFFICIENT DETAIL TO LOCATE IN FUTURE? YANY NO N <br /> COMMENTS:WE ABOVE R QUIRE PERMIT TO B-3 Q AI <br /> (C Jt'f �07 e,-,x <br /> /2 /� o- a � -77 <br /> Sp on, jec� <br /> INSPECTED BY:�o-� I � DATE: <br />
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