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SR0080322
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0080322
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Entry Properties
Last modified
5/20/2019 2:20:03 PM
Creation date
5/20/2019 2:04:47 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0080322
PE
4210
STREET_NUMBER
4384
Direction
W
STREET_NAME
PINE HAVEN
STREET_TYPE
DR
City
TRACY
Zip
95304
APN
23908073
ENTERED_DATE
3/13/2019 12:00:00 AM
SITE_LOCATION
4384 W PINE HAVEN DR
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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AMeuangkhoth
Tags
EHD - Public
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SEPTIC SYSTEM INSPECTION CHECK LIST <br /> ADDRESS: ,3g� w, i..t ,z.,- ,DA PERMIT# S-, DWo 0 S ZZ <br /> Check box ACTUAL MEETS SJC <br /> PARAMETER if inspected MEASUREMENT STANDARDS? COMMENTS <br /> SEPTICTANK: <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: X19 <br /> DISTANCE FROM TANK? Y N <br /> DISTANCE TO NEAREST LEACH LINE? Y N <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? Y N <br /> IS D-BOX LEVEL? Y N <br /> OTHER Y N <br /> LEACH FIELD: (LL=LE LINES)�•l << <br /> DISTANCE TO PROPERTY LINE? 3A / N <br /> DISTANCE TO ANY WATER WELLS? 1071 N <br /> DISTANCE TO NEAREST FOUNDATION? YZ N <br /> DISTANCE OF SOIL BARRIER BETWEEN LL'S? ® Y N <br /> CORRECT DEPTH OF LL TRENCHES? 7 3�� N KL1�7R.P <br /> CORRECT DEPTH AND TYPE OF ROCK? N <br /> CORRECT WIDTH OF LL TRENCHES? Y N �'JQf ti <br /> CORRECT LENGTH OF LL TRENCHES? Y N <br /> CORRECT TYPE OF PIPING? sp12 P 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? iP N <br /> ANY NO ANSWER ABOVE REQUIRES PERMIT TO BE REDRAWN. <br /> COMMENTS: t-I r4( 1 n5 p4 CA, �q• t/Y1C1 v���+ '�'� �'�h k>-aa <br /> l\nS uc a .t 7a • e-gg he c i• lagU <br /> INSPECTED BY: �,,.—�� � DATE: <br />
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