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SR0081165
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4200/4300 - Liquid Waste/Water Well Permits
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SR0081165
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Last modified
2/12/2020 2:15:35 PM
Creation date
2/12/2020 1:21:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0081165
PE
4210
FACILITY_NAME
19292 N ATKINS RD
STREET_NUMBER
19292
Direction
N
STREET_NAME
ATKINS
STREET_TYPE
RD
City
CLEMENTS
Zip
95227
APN
01920042
ENTERED_DATE
9/17/2019 12:00:00 AM
SITE_LOCATION
19292 N ATKINS 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: ci �{ �}— 00 < > PERMIT# S h p O 5 <br /> Check box ACTUAL MEETS SJC <br /> PARAMETER if inspected MEASUREMENT STANDARDS? COMMENTS <br /> SEPTIC TANK: <br /> CORRECT TANK CAPACITY? Y N <br /> DISTANCE TO FOUNDATION? Y N <br /> DISTANCE TO PROPERTY LINE? Y N <br /> DISTANCE TO ANY WELLS? Y N <br /> TANK LEVEL AND ORIENTED CORRECTLY? Y N <br /> SANITARY TEES CORRECTLY INSTALLED? Y N <br /> CORRECT TYPE OF PIPING? Y N <br /> TANK VENTED? Y N <br /> ANY TANK ABNORMALITIES NOTED? Y N <br /> OTHER Y N <br /> DISTRIBUTION BOX: <br /> I <br /> DISTANCE FROM TANK? N <br /> DISTANCE TO NEAREST LEACH LINE? It) N <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? N <br /> IS D-BOX LEVEL? J (, © N <br /> OTHER Y N <br /> LEACH FIELD: (LL=LEACH LINES) <br /> DISTANCE TO PROPERTY LINE? 2s, N <br /> DISTANCE TO ANY WATER WELLS? N <br /> DISTANCE TO NEAREST FOUNDATION? Q Q N } l f�MQ � <br /> DISTANCE OF SOIL BARRIER BETWEEN LL'S? Ny <br /> CORRECT DEPTH OF LL TRENCHES? N <br /> CORRECT DEPTH AND TYPE OF ROCK? y1'�N ® N <br /> CORRECT WIDTH OF LL TRENCHES? 1� k N ® N <br /> CORRECT LENGTH OF LL TRENCHES? v' alb, O N <br /> CORRECT TYPE OF PIPING? t�WL - ® N <br /> OTHER Y N <br /> SEEPAGE PITS: i <br /> DISTANCE TO PROPERTY LINE? Nft <br /> � JNS�F(fl�r��l�t6QDR'( <br /> DISTANCE TO ANY WATER WELLS? 3 4 0' N 01Q 1.F t j i/ell 9 <br /> DISTANCE TO NEAREST FOUNDATION? Zip' N Vin i1 Q-4kJS&-hDISTANCE OF SOIL BARRIER TO PITS? �o N A UJ f bgb,,;,t.J <M p) <br /> CORRECT DEPTH AND TYPE OF ROCK? <br /> CORRECT WIDTH? ul�l N <br /> OTHER EflY N <br /> MISCELLANEOUS: <br /> DOES PERMIT DRAWING REFLECT ACCURATE LOCATION OF SYSTEM? ® N <br /> DOES PERMIT DRAWING SHOW SUFFICIENT DETAIL TO LOCATE IN FUTURE? N <br /> ANY NO ANSWER ABOVE REQUIRES PERMIT TO BE REDRAWN, <br /> COMMENTS: <br /> S� R)A.) <br /> ( ESP- b P f ' k- <br /> • INSPECTED BY� DATE: 2 <br />
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