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SEPTIC SYSTEM INSPECTION CHECK LIST <br />ADDRESS: /7g-or- PERMIT # 77 4 <br />Check box ACTUAL <br />PARAMETER if inspected MEASUREMENT <br />MEETS SJC <br />STANDARDS? COMMENTS <br />SEPTIC TANK: <br />CORRECT TANK CAPACITY?. <br />DISTANCE TO FOUNDATION? <br />DISTANCE TO PROPERTY LINE? <br />DISTANCE TO ANY WELLS? <br />TANK LEVEL AND ORIENTED CORRECTLY? <br />SANITARY TEES CORRECTLY INSTALLED? <br />CORRECT TYPE OF PIPING? <br />TANK VENTED? <br />ANY TANK ABNORMALITIES NOTED? <br />OTHER ' <br />/-1-1 N /_e,oe„—. <br />' e.9 . N <br />/ 3 `3 C-.V N <br />." jc, 0 42 0 •,,, 5 1.,-N N <br />..- — Y N <br />Y N <br />Y N <br />Y N <br />— Y <br />Y <br />N <br />N <br />DISTRIBUTION BOX: <br />DISTANCE FROM TANK? <br />DISTANCE TO NEAREST LEACH LINE? <br />DOES SYSTEM HAVE EQUAL DISTRIBUTION? <br />IS D-BOX LEVEL? <br />OTHER <br />/ '°, 7 q--- <br />Id <br />'f) <br />dr <br />.?" <br />N F <br />- 5- N <br />— N <br />N <br />- N <br />LEACH FIELD: (LL= LEACH LINES) _ - , <br />DISTANCE TO PROPERTY LINE? <br />DISTANCE TO ANY WATER WELLS? <br />DISTANCE TO NEAREST FOUNDATION? <br />DISTANCE OF SO'L BARRIER BETWEEN LL'S? <br />CORRECT DEPTH OF LL TRENCHES? <br />CORRECT DEPTH AND TYPE OF ROCK? <br />CORRECT WIDTH OF LL TRENCHES? <br />CORRECT LENGTH OF LL TRENCHES? <br />CORRECT TYPE OF PIPING? <br />OTHER <br />/4) d- <br />65 <br />Y <br />,15 <br />,,ii3 <br />213 <br />--P <br />71F <br />(-- Y <br />N <br />i .J 0 ,..) (v.' 5 N I <br />---; D . N - <br />..--- N <br />1/2- ' N <br />/5 „. N / <br />2_D )( //0 N <br />IW /X16- N <br />-- N <br />N <br />SEEPAGE PITS: <br />DISTANCE TO ROPERTY LINE? <br />DISTANCE ANY WATER WELLS? <br />DISTANC 0 NEAREST FOUNDATION? <br />DISTA E OF SOIL BARRIER TO PITS? <br />COR CT DEPTH AND TYPE OE ROCK? <br />CO ECT WIDTH? <br />0 ER <br />Y <br />Y <br />Y <br />Y <br />Y <br />Y <br />Y <br />N <br />N if <br />N 7' <br />/ <br />N / <br />N / <br />N , <br />N <br />MISCELLANEOUS: <br />DOES PERMIT DRAWING REFLECT ACCURATE LOCATION OF SYSTEM? <br />DOES PERMIT DRAWING SHOW SUFFICIENT DETAIL TO LOCATE IN FUTURE? <br />ANY NO ANSWER ABOVE REQUIRES PERMIT TO BE REDRAWN. <br />COMN TS: <br />(y <br />0 <br />N <br />N <br />, <br />INSPECTED BY: - DATE: • ,z(zir/7