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SR0081154
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0081154
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Entry Properties
Last modified
5/12/2020 3:35:44 PM
Creation date
5/12/2020 2:58:34 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0081154
PE
4211
FACILITY_NAME
2515 W SARGENT RD
STREET_NUMBER
2515
Direction
W
STREET_NAME
SARGENT
STREET_TYPE
RD
City
LODI
Zip
95242
APN
02516062
ENTERED_DATE
9/13/2019 12:00:00 AM
SITE_LOCATION
2515 W 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: PERMIT <br /> Check box ACTUAL MEETS SJC <br /> PARAMETER If Inspected MEASUREMENT STANDARDS? CQMMENTS <br /> SEPTIC TANK: i <br /> CORRECT TANK CAPACITY? Z (� Y N <br /> DISTANCE TO FOUNDATION? r _ N <br /> DISTANCE TO PROPERTY LINE? N <br /> DISTANCF TO ANY WELLS? �/.u� N <br /> TANK LEVEL AND ORIENTED CORRECTLY? Ay ) N <br /> SANITARY TEES CORRECTLY INSTALLED? (0 <br /> CORRECT TYPE OF PIPING? N <br /> TANK VENTED 7 f~ N <br /> ANY•TANKABNORMALITIES NOTED? Y N <br /> OTHER Y N <br /> DISTRIBUTION BOX: <br /> DISTANCE FROM TANK? y. til' N <br /> DISTANCE TO NEAREST LEACHLINE7 2, Y S' <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? (9 N <br /> ISD-BOX LEVEL? iAl �J N <br /> OTHER Y N <br /> LEACH FIELD: (LL=LF,CH LINES) ' <br /> DISTANCE TO PROPERTY LINE? �j t✓l N <br /> DISTANCE TO ANY WATER WELLS? � , �;(' (� N <br /> DISTANCE TO NEAREST FOUNDATION? -TN N - /I <br /> DISTANCE OF SOIL BARRIER BETWEEN LL'S7 1Y N &.'l <br /> CORRECT DEPTH OF LL TRENCHES? Y <br /> CORRECT DEPTH AND TYPE OF ROCK? r 1 Y k e s <br /> CORRECT WIDTH OF LL TRENCHES? �i)�;� N <br /> CORRECT LENGTH OF LL TRENCHES? k N <br /> CORRECT TYPE OF PIPING? Y N <br /> OTHER N ' S 41 <br /> SEEPAGE PITS: �jEJ C k vrt �L� <br /> DISTANCE TO PROPERTY LINE? Y N �( � ' 1' C�� vix <br /> DISTANCE TO ANY WATER WELLS? Y N <br /> DISTANCE TO NEAREST FOUNDATION? Y N <br /> DISTANCE OF SOIL BARRIER TO PITS? Y N <br /> CORRECT DEPTH AND TYPE OF ROCK? Y N <br /> CORRECTWIDTH? Y N <br /> OTHER Y N <br /> MISCELLANEOUS: <br /> DOES PERMIT DRAWING REFLECTACCURATE LOCATION OF SYSTEM? Y N <br /> DOES PERMIT DRAWING SHOW SUFFICIENT DETAIL TO LOCATE IN FUTURE_? Y N <br /> ANY NO ANSWER ABOVE RF RESPEMITTOBEREDRAVVP. <br /> COMMENTS: ma <br /> Ilk 0 <br /> rv► - <br /> .l0, - ( ct ria ,• d1 >v- ,r .k <br /> �ti iu Y r G Q '>elA G' S <br /> INSPECTED BY: DATE: / <br /> y to � . <br />
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