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SR0081032
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0081032
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Last modified
11/26/2019 9:28:30 AM
Creation date
11/26/2019 9:25:36 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0081032
PE
4210
STREET_NUMBER
15757
Direction
E
STREET_NAME
SARGENT
STREET_TYPE
RD
City
LODI
Zip
95240
APN
05307006
ENTERED_DATE
8/13/2019 12:00:00 AM
SITE_LOCATION
15757 E SARGENT 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: S a r' tvk PERMIT# (e' <br /> Check box ACTUAL MEETS SJC <br /> PARAMETER if inspected MEASUREMENT STANDARDS? COMMENTS <br /> SEPTIC TANK: <br /> CORRECT TANK CAPACITY? (fbQ Q �Y N <br /> DISTANCE TO FOUNDATION? 3 Q N <br /> DISTANCE TO PROPERTY LINE? G� OY N <br /> DISTANCE TO ANY WELLS? r N <br /> TANK LEVEL AND ORIENTED CORRECTLY? V/ Cf N <br /> SANITARY TEES CORRECTLY INSTALLED? V N <br /> CORRECT TYPE OF PIPING? L35 Y N <br /> TANK VENTED? Y N <br /> ANY TANK ABNORMALITIES NOTED? Y N <br /> OTHER Y N <br /> DISTRIBUTION BOX: <br /> DISTANCE FROM TANK? 35 N <br /> DISTANCE TO NEAREST LEACH LINE? 7 N <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? SY <br /> N <br /> IS D-BOX LEVEL? (/ N <br /> OTHER Y N <br /> LEACH FIELD: (LL=LEACH LINES) <br /> DISTANCE TO PROPERTY LINE? Cj�'}- Y� N <br /> DISTANCE TO ANY WATER WELLS? N <br /> DISTANCE TO NEAREST FOUNDATION? (p -- - Y N <br /> DISTANCE OF SOIL BARRIER BETWEEN LL'S? Y N <br /> CORRECT DEPTH OF LL TRENCHES? 2 / ® N <br /> CORRECT DEPTH AND TYPE OF ROCK? / l Y N / 2 (1 f oc ki ii-A �(Tl <br /> CORRECT WIDTH OF LL TRENCHES? 2-1 N <br /> CORRECT LENGTH OF LL TRENCHES? Lb� (� N <br /> CORRECT TYPE OF PIPING? N <br /> OTHER Y N <br /> SEEPAGE PITS: <br /> DISTANCE TO PROPERTY LINE? �/ �! © N <br /> DISTANCE TO ANY WATER WELLS? /+ © N <br /> DISTANCE TO NEAREST FOUNDATION? C-7-f— N <br /> DISTANCE OF SOIL BARRIER TO PITS? j n l © N <br /> CORRECT DEPTH AND TYPE OF ROCK? 2,5 OY N 2 (Z I n['o GLV-g rbLL �,Lb <br /> CORRECT WIDTH? i-I2-11 © 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: tf � DATE: to/2-2-//j <br />
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