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SR0081935
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0081935
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Last modified
5/14/2020 2:06:12 PM
Creation date
5/14/2020 1:56:12 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0081935
PE
4210
STREET_NUMBER
24842
STREET_NAME
DUSTIN
STREET_TYPE
RD
City
ACAMPO
Zip
95220
APN
00704013
ENTERED_DATE
3/25/2020 12:00:00 AM
SITE_LOCATION
24842 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: r Z I t i lil,- i PERMIT# <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 J 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 /> DISTANCE FROM TANK? AID N <br /> DISTANCE TO NEAREST LEACH LINE? ;/ N <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? N <br /> IS D-BOX LEVEL? i/ N <br /> OTHER Y N <br /> LEACH FIELD: (LL=LEACH LINES) <br /> DISTANCE TO PROPERTY LINE? CD N <br /> DISTANCE TO ANY WATER WELLS? Y N <br /> DISTANCE TO NEAREST FOUNDATION? / Y N <br /> DISTANCE OF SOIL BARRIER BETWEEN LL'S? Y N <br /> CORRECT DEPTH OF LL TRENCHES? Y N <br /> CORRECT DEPTH AND TYPE OF ROCK? J j' Y N t-2112- iywt�i)Ltta J7�d 5/fZi . <br /> CORRECT WIDTH OF LL TRENCHES? (Y N <br /> CORRECT LENGTH OF LL TRENCHES? L{ n Y N <br /> CORRECT TYPE OF PIPING? ����5� �Y) N <br /> OTHER Y N <br /> SEEPAGE PITS: <br /> DISTANCE TO PROPERTY LINE? / /-� N <br /> DISTANCE TO ANY WATER WELLS? sy N <br /> DISTANCE TO NEAREST FOUNDATION? ✓ / N <br /> DISTANCE OF SOIL BARRIER TO PITS? Y N <br /> CORRECT DEPTH AND TYPE OF ROCK? � Y N I ,) /, I I I d �:L`Cj Y,( sJ2— <br /> CORRECT WIDTH? e) 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: � � [� _,�� DATE: -3 12- 2� L <br />
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