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SR0082201
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0082201
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Last modified
7/1/2020 2:17:16 PM
Creation date
7/1/2020 1:55:04 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0082201
PE
4210
FACILITY_NAME
25670 E ELM ST
STREET_NUMBER
25670
Direction
E
STREET_NAME
ELM
STREET_TYPE
ST
City
FARMINGTON
Zip
95230
APN
18722033
ENTERED_DATE
6/16/2020 12:00:00 AM
SITE_LOCATION
25670 E ELM ST
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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TSok
Tags
EHD - Public
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SEPTIC SYSTEM INSPECTION CHECK LIST <br /> ADDRESS: 2 F PERMIT# 0 g 2 6 <br /> Check box ACTUAL MEETS SJC <br /> PARAMETER if inspected MEASUREMENT STANDARDS? COMMENTS <br /> SEPTIC TANK: <br /> CORRECT TANK CAPACITY? L� / YO N <br /> DISTANCE TO FOUNDATION? N <br /> DISTANCE TO PROPERTY LINE? N <br /> DISTANCE TO ANY WELLS? Y NAa f� J <br /> TANK LEVEL AND ORIENTED CORRECTLY? N <br /> SANITARY TEES CORRECTLY INSTALLED? N <br /> CORRECT TYPE OF PIPING? S®�?� N <br /> TANK VENTED? ,/ Y N <br /> ANY TANK ABNORMALITIES NOTED? Y N <br /> OTHER Y N <br /> DISTRIBUTION BOX: <br /> DISTANCE FROM TANK? N <br /> DISTANCE TO NEAREST LEACH LINE? N <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? .- N <br /> IS D-BOX LEVEL? y,., N <br /> OTHER Y N <br /> LEACH FIELD: (LL=LEACH LINES) <br /> DISTANCE TO PROPERTY LINE? y', �� ®Y N <br /> DISTANCE TO ANY WATER WELLS? Y N <br /> DISTANCE TO NEAREST FOUNDATION? 2,5-1 N <br /> DISTANCE OF SOIL BARRIER BETWEEN LUS? /20 N <br /> CORRECT DEPTH OF LL TRENCHES? 40// ( N <br /> CORRECT DEPTH AND TYPE OF ROCK? IP ITY[� N <br /> CORRECT WIDTH OF LL TRENCHES? 2- 57- N <br /> CORRECT LENGTH OF LL TRENCHES? y/ 'G.S N <br /> CORRECT TYPE OF PIPING? y/ SnR3-51— N <br /> OTHER Y N <br /> SEEPAGE PITS: <br /> DISTANCE TO PROPERTY LINE? j/ 'Lrj�4- �Y N <br /> DISTANCE TO ANY WATER WELLS? Y N �1 <br /> DISTANCE TO NEAREST FOUNDATION? y.' -� N <br /> DISTANCE OF SOIL BARRIER TO PITS? N <br /> CORRECT DEPTH AND TYPE OF ROCK? L N j v ,L f(irk avci rars j'zg <br /> CORRECT WIDTH? /�'��✓ CYC 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: <br />
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