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SR0081026
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4200/4300 - Liquid Waste/Water Well Permits
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SR0081026
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Last modified
9/6/2019 3:40:36 PM
Creation date
9/6/2019 3:05:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0081026
PE
4210
STREET_NUMBER
23081
Direction
S
STREET_NAME
HANSEN
STREET_TYPE
RD
City
TRACY
Zip
95304
APN
20938001
ENTERED_DATE
8/12/2019 12:00:00 AM
SITE_LOCATION
23081 S HANSEN RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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SEPTIC SYSTEM 1NSPEGTION GHEGK LIST <br /> ADDRESS: PERMIT# <br /> Cherk box ACTUAL MEETSSJC <br /> PARAMETER If inspected MEASUREMENT STANDARDS? CQMMENTS <br /> SEPTIC TANK: <br /> CORRECTTANKCAPANTY? Y N <br /> DISTANCE TO FOUNDATION? Y N <br /> DISTANCE TO PROPERTY LINE? Y <br /> DISTANCF TO ANY WELLS? N <br /> TANKLEVEL AND ORIENTED CORRECTLY? Y N <br /> SANITARY TEES CORRECTLYINSTALLED? �'�� N <br /> CORRECTTYPE OF PIPING? �' TI <br /> TANKVENTED? Y N <br /> ANY TANKABNORMALITIESNOTED? Y N <br /> OTHER Y N <br /> DISTRIBUTION BOX 1 <br /> DISTANCE FROM TANK? l 7j N <br /> DISTANCETO NEARESTLEACH LINE? :2 4j' N <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? N <br /> 1S D-BOX LEVEL? N <br /> OTHER Y N <br /> LEACH FIELD: (LL=LEACH LINES) kV <br /> 1 <br /> DISTANCE TO PROPERTY LINE? Y N <br /> ')ISTANCETOANYWATERWELLS? N <br /> DISTANCETO NEARESTFOUNDATION? i Y N - <br /> DISTANCE OF SOIL BARRIER BETWEEN LU'S? N A J <br /> CORRECT DEPTH OF LLTRENGHES? �"�- " Y N <br /> CORRECT DEPTH AND TYPE OF ROCK? Y N ro <br /> CORRECTWIDTH OF TRENCHES? Y N <br /> CORRECT LENGTH OF LL TRENCHES? N <br /> CORRECTTYPE OF PIPING? < N <br /> OTHER N <br /> SEEPAGE PITS: <br /> DISTANCE TO PROPERTY LINE? Y N _ <br /> DISTANCETO ANY WATER WELLS? Y N <br /> DISTANCETONEAREST FOUNDATION? Y N <br /> DISTANCE OF SOIL BARRIER TO PITS? Y N <br /> CORRECTDEPTH AND TYPE OF ROCK? Y N <br /> CORREGTWIDTH? Y N <br /> OTHER Y N <br /> MISCELLANEOUS: <br /> DOES PERMIT DRAWING REFLECTACCURATE LOCATION OFSYSTEM? Y N <br /> DOES PERMIT DRAWING SHOW SUFFICIENT DETAIL TO LOCATE IN FUTURE? Y N <br /> ANY HO ANSWER ABOVE REQUIRES PERMITTO BE REDRAWN. <br /> COMMENTS: <br /> INSPECTED BY: DATE: - <br /> J ' <br />
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