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SR0082103
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4200/4300 - Liquid Waste/Water Well Permits
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SR0082103
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Last modified
6/25/2020 11:22:44 AM
Creation date
6/25/2020 10:18:52 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0082103
PE
4210
FACILITY_NAME
27770 S CHRISMAN RD
STREET_NUMBER
27770
Direction
S
STREET_NAME
CHRISMAN
STREET_TYPE
RD
City
TRACY
Zip
95376
APN
25209003
ENTERED_DATE
5/20/2020 12:00:00 AM
SITE_LOCATION
27770 S CHRISMAN RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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SEPTIC SYSTEM INSPECTION CHECK LIST <br /> ADDRESS: -7 Q S P`r ' 1, r L PERMIT# 2 I 3 <br /> Check box ACTUAL MEETS SJC <br /> PARAMETER if inspected MEASUREMENT STANDARDS? COMMENTS <br /> SEPTIC TANK: <br /> CORRECT TANK CAPACITY? ✓ 2 0 0 0 N <br /> DISTANCE TO FOUNDATION? 2/ Y N <br /> DISTANCE TO PROPERTY LINE? so"-t- N <br /> DISTANCE TO ANY WELLS? N <br /> TANK LEVEL AND ORIENTED CORRECTLY? N <br /> SANITARY TEES CORRECTLY INSTALLED? N <br /> CORRECT TYPE OF PIPING? v--- N <br /> TANK VENTED? Y N <br /> ANY TANK ABNORMALITIES NOTED? Y N <br /> OTHER Y N <br /> DISTRIBUTION BOX: <br /> DISTANCE FROM TANK? t/ I � N <br /> DISTANCE TO NEAREST LEACH LINE? 5j 7 N <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? ✓ N <br /> IS D-BOX LEVEL? *</ N <br /> OTHER Y N <br /> LEACH FIELD: (LL=LEACH LINES) <br /> DISTANCE TO PROPERTY LINE? j f N <br /> DISTANCE TO ANY WATER WELLS? ��L / N <br /> DISTANCE TO NEAREST FOUNDATION? /f� N <br /> DISTANCE OF SOIL BARRIER BETWEEN LUS? vl- N <br /> CORRECT DEPTH OF LL TRENCHES? (2) N <br /> CORRECT DEPTH AND TYPE OF ROCK? Y N <br /> CORRECT WIDTH OF LL TRENCHES? 2 S7 © N <br /> CORRECT LENGTH OF LL TRENCHES? C 2/ � N <br /> CORRECT TYPE OF PIPING? N <br /> OTHER Y N <br /> SEEPAGE PITS: <br /> DISTANCE TO PROPERTY LINE? Y N <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 /> CORRECT WIDTH? Y 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: T I/Q _ _ , DATE:b 6 6 2 17-0 <br />
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