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SR0080474
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4200/4300 - Liquid Waste/Water Well Permits
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SR0080474
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Entry Properties
Last modified
5/20/2019 2:34:03 PM
Creation date
5/20/2019 2:11:45 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0080474
PE
4210
STREET_NUMBER
11750
Direction
N
STREET_NAME
DE VRIES
STREET_TYPE
RD
City
LODI
Zip
95242
APN
05522022
ENTERED_DATE
4/12/2019 12:00:00 AM
SITE_LOCATION
11750 N DE VRIES RD
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
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AMeuangkhoth
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EHD - Public
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SEPTIC SYSTEM INSPECTION CHECK LIST <br /> ADDRESS: SD77 0e F r _ PERMIT# &Q D t-{-7 y <br /> Check box ACTUAL MEETS SJC <br /> PARAMETER if inspected MEASUREMENT STANDARDS? COMMENTS <br /> SEPTIC TANK: ��77 <br /> CORRECT TANK CAPACITY? L io 0 N <br /> DISTANCE TO FOUNDATION? N <br /> DISTANCE TO PROPERTY LINE? N <br /> DISTANCE TO ANY WELLS? O L-( [ - N <br /> TANK LEVEL AND ORIENTED CORRECTLY? ✓ N <br /> SANITARY TEES CORRECTLY INSTALLED? LTJ N <br /> CORRECT TYPE OF PIPING? N <br /> TANK VENTED? ✓ N <br /> ANY TANK ABNORMALITIES NOTED? Y N <br /> OTHER Y N <br /> DISTRIBUTION BOX: <br /> DISTANCE FROM TANK? \/ `j -j F N <br /> DISTANCE TO NEAREST LEACH LINE? �/ 7j �� V N <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? p y�z 'r L YYN <br /> IS D-BOX LEVEL? Q N <br /> OTHER Y N <br /> LEACH FIELD: (LL=LEACH LINES) ( r <br /> DISTANCE TO PROPERTY LINE? ✓ { N <br /> DISTANCE TO ANY WATER WELLS? LOO r4 119 Y N IGO' of 1, Well 119' �;> �� livt I I ac✓O`J Surae( <br /> DISTANCE TO NEAREST FOUNDATION? 11 Tll Y N <br /> DISTANCE OF SOIL BARRIER BETWEEN LL'S? Y N cL <br /> CORRECT DEPTH OF LL TRENCHES? V _I i n Y N LP 12L <br /> CORRECT DEPTH AND TYPE OF ROCK? �/ �� '� Y N <br /> CORRECT WIDTH OF LL TRENCHES? IF 4 N <br /> CORRECT LENGTH OF LL TRENCHES? ✓ '3 5" R N <br /> CORRECT TYPE OF PIPING? fKTM D 7-12 N <br /> OTHER Y N <br /> SEEPAGE PITS: <br /> DISTANCE TO PROPERTY LINE? v/ <br /> 1 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 El 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? l.% N <br /> ANY NO ANSWER ABOVE REQUIRES PERMIT TO BE REDRAWN.f '/ I (_ J <br /> COMMENTS: i 0 I S t►c- '7 r.�vt f� (�eikrL�-(-6-o k7 O I A S C Q-✓1 k wo <br /> 2-3 ypwn 4- oto a., n mac , Own I� <br /> —S-A-) <br /> C D <br /> INSPECTED Bry w/ ^ /� DATE: I ` <br />
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