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SR0080676
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0080676
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Last modified
7/24/2019 2:27:22 PM
Creation date
7/24/2019 1:53:54 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0080676
PE
4210
STREET_NUMBER
10837
Direction
W
STREET_NAME
CLOVER
STREET_TYPE
RD
City
TRACY
Zip
95376
APN
21418010
ENTERED_DATE
5/29/2019 12:00:00 AM
SITE_LOCATION
10837 W CLOVER RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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SEPTIC SYSTEM INSPECTION CHECK LIST <br /> ADDRESS: Lo w PERMIT# 0 <br /> Check box ACTUAL MEETS SJC <br /> PARAMETER 40 if inspected MEASUREMENT STANDARDS? COMMENTS <br /> SEPTIC TANK: <br /> CORRECT TANK CAPACITY? ( UU p ' N <br /> DISTANCE TO FOUNDATION? ✓ YCD N <br /> DISTANCE TO PROPERTY LINE? ✓ ( N <br /> DISTANCE TO ANY WELLS? 1122N <br /> TANK LEVEL AND ORIENTED CORRECTLY? N <br /> SANITARY TEES CORRECTLY INSTALLED? ✓ N <br /> CORRECT TYPE OF PIPING? �/ S�(��S N <br /> TANK VENTED? ✓ Y N <br /> ANY TANK ABNORMALITIES NOTED? Y N <br /> OTHER Y N <br /> DISTRIBUTION BOX: <br /> DISTANCE FROM TANK? -Q) N <br /> DISTANCE TO NEAREST LEACH LINE? N <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? N <br /> IS D-BOX LEVEL? V N <br /> OTHER Y N <br /> LEACH FIELD: (LL=LEACH LINES <br /> DISTANCE TO PROPERTY LINE? N <br /> DISTANCE TO ANY WATER WELLS? 1/ YJ N <br /> DISTANCE TO NEAREST FOUNDATION? �/ YQ N <br /> DISTANCE OF SOIL BARRIER BETWEEN LUS? t/ t 0 f-✓C N <br /> CORRECT DEPTH OF LL TRENCHES? 3 (� i yt Y N <br /> CORRECT DEPTH AND TYPE OF ROCK? — Y N <br /> CORRECT WIDTH OF LL TRENCHES? `/ 2 (1� N <br /> CORRECT LENGTH OF LL TRENCHES? N <br /> CORRECT TYPE OF PIPING? �� Q Z /vim 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? l?y N <br /> DOES PERMIT DRAWING SHOW SUFFICIENT DETAIL TO LOCATE IN FUTURE? Y N <br /> ANY NO ANSWER ABOVE REQUIRES PERMIT TO BE REDRAWN. <br /> COMMENTS: <br /> INSPECTED BY�- �i� � ��` DATE: <br />
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