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SR0080499
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4200/4300 - Liquid Waste/Water Well Permits
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SR0080499
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Last modified
7/31/2019 9:06:47 AM
Creation date
7/31/2019 9:03:47 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0080499
PE
4211
STREET_NUMBER
16820
Direction
N
STREET_NAME
LOCUST TREE
STREET_TYPE
RD
City
LODI
Zip
95240
APN
05112092
ENTERED_DATE
4/18/2019 12:00:00 AM
SITE_LOCATION
16820 N LOCUST TREE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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SEPTIC SYSTEM INSPECTION CHECK LIST <br /> ADDRESS: PERMIT# <br /> Check box ACTUAL MEETS SJC <br /> PARAMETER if inspected MEASUREMENT STANDARDS? COMMENTS <br /> SEPTIC TANK: <br /> CORRECT TANK CAPACITY? ✓ ( CJ N <br /> DISTANCE TO FOUNDATION? (Y) N <br /> DISTANCE TO PROPERTY LINE? 1J N <br /> DISTANCE TO ANY WELLS? N <br /> TANK LEVEL AND ORIENTED CORRECTLY? \/ N <br /> SANITARY TEES CORRECTLY INSTALLED? V-1 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? N <br /> DISTANCE TO NEAREST LEACH LINE? k/ N <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? N <br /> IS D-BOX LEVEL? ✓ 1 N <br /> OTHER Y N <br /> LEACH FIELD: (LL=LEACH LINES) _r"IH lty- ll- <br /> DISTANCE TO PROPERTY LINE? t/ 6O} Y N <br /> DISTANCE TO ANY WATER WELLS? ........ <br /> 006 N <br /> DISTANCE TO NEAREST FOUNDATION? N <br /> DISTANCE OF SOIL BARRIER BETWEEN LL'S? Y N <br /> CORRECT DEPTH OF LL TRENCHES? m 01a N <br /> CORRECT DEPTH AND TYPE OF ROCK? Y N <br /> CORRECT WIDTH OF LL TRENCHES? OY N <br /> CORRECT LENGTH OF LL TRENCHES? 0 N <br /> CORRECT TYPE OF PIPING? Y N <br /> OTHER Y N <br /> SEEPAGE PITS: ( y <br /> DISTANCE TO PROPERTY LINE? N <br /> DISTANCE TO ANY WATER WELLS? �/' I.S� -�-- N <br /> DISTANCE TO NEAREST FOUNDATION? N <br /> DISTANCE OF SOIL BARRIER TO PITS? (Q,S N <br /> CORRECT DEPTH AND TYPE OF ROCK? N 1 2 2 l�flf�G 11 QnMI 12 f k— <br /> CORRECT WIDTH? N <br /> OTHER Y N <br /> MISCELLANEOUS: <br /> DOES PERMIT DRAWING REFLECT ACCURATE LOCATION OF SYSTEM? 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: � DATE: <br />
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