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SR0081603
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4200/4300 - Liquid Waste/Water Well Permits
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SR0081603
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Last modified
3/11/2020 4:57:20 PM
Creation date
3/11/2020 4:14:47 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0081603
PE
4210
STREET_NUMBER
23836
Direction
N
STREET_NAME
DUSTIN
STREET_TYPE
RD
City
ACAMPO
Zip
95220
APN
00705033
ENTERED_DATE
1/8/2020 12:00:00 AM
SITE_LOCATION
23836 N DUSTIN 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: L PERMIT# CS/2c7o / <br /> Check box ACTUAL MEETS SJC <br /> PARAMETER if inspected MEASUREMENT STANDARDS? COMMENTS <br /> SEPTIC TANK: <br /> CORRECT TANK CAPACITY? N <br /> DISTANCE TO FOUNDATION? N <br /> DISTANCE TO PROPERTY LINE? ! r N <br /> DISTANCE TO ANY WELLS? I.S2 N <br /> TANK LEVEL AND ORIENTED CORRECTLY? ,/ .— N <br /> SANITARY TEES CORRECTLY INSTALLED? N <br /> CORRECT TYPE OF PIPING? 3.j N <br /> TANK VENTED? 9> N <br /> ANY TANK ABNORMALITIES NOTED? e' N <br /> OTHER Y N <br /> DISTRIBUTION BOX: <br /> DISTANCE FROM TANK? /6� N <br /> DISTANCE TO NEAREST LEACH LINE? s' N <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? m N <br /> IS D-BOX LEVEL? r-- N <br /> OTHER Y N <br /> LEACH FIELD: (LL=LEACH LINES) / <br /> DISTANCE TO PROPERTY LINE? Ip. N <br /> DISTANCE TO ANY WATER WELLS? S t r N <br /> DISTANCE TO NEAREST FOUNDATION? N <br /> DISTANCE OF SOIL BARRIER BETWEEN LL'S? 0, /�s iy N <br /> CORRECT DEPTH OF LL TRENCHES? C) N <br /> CORRECT DEPTH AND TYPE OF ROCK? !3r;, •/ �� 1p N <br /> CORRECT WIDTH OF LL TRENCHES? Z 0 N <br /> CORRECT LENGTH OF LL TRENCHES? N <br /> CORRECT TYPE OF PIPING? Y"K Li•/�ci s N <br /> OTHER Y N <br /> SEEPAGE PITS: <br /> DISTANCE TO PROPERTY LINE? / 41 N <br /> DISTANCE TO ANY WATER WELLS? & N <br /> DISTANCE TO NEAREST FOUNDATION? 3(r 0 N <br /> DISTANCE OF SOIL BARRIER TO PITS? 240 q' q 0 N <br /> CORRECT DEPTH AND TYPE OF ROCK? Zs'd — a N <br /> CORRECT WIDTH? ® N <br /> OTHER Y 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 /> INSPECTED BY: DATE: <br />
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