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SR0082310
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0082310
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Last modified
7/22/2020 11:09:45 AM
Creation date
7/22/2020 10:59:25 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0082310
PE
4210
STREET_NUMBER
19255
STREET_NAME
BRANDT
STREET_TYPE
RD
City
LODI
Zip
95240
APN
01920036
ENTERED_DATE
7/9/2020 12:00:00 AM
SITE_LOCATION
19255 BRANDT 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: l9 2 PERMIT# L 0 <br /> Check box ACTUAL MEETS SJC <br /> PARAMETER if inspected MEASUREMENT STANDARDS? COMMENTS <br /> SEPTIC TANK: .C�b <br /> CORRECT TANK CAPACITY-?v Y N <br /> DISTANCE TO FOUNDATION? Y N <br /> DISTANCE TO PROPERTY LINE? Y 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? Y N <br /> DISTANCE TO NEAREST LEACH LINE? Y N <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? Y N <br /> IS D-BOX LEVEL? Y N <br /> OTHER Y N <br /> LEACH FIELD: (LL=LEACH LINES) <br /> DISTANCE TO PROPERTY LINE? loo ��d �� N <br /> DISTANCE TO ANY WATER WELLS? v000, Ityc) N <br /> DISTANCE TO NEAREST FOUNDATION? N <br /> DISTANCE OF SOIL BARRIER BETWEEN LUS? Y N <br /> CORRECT DEPTH OF LL TRENCHES? �(p" SE" N wGa, it <br /> CORRECT DEPTH AND TYPE OF ROCK? N <br /> CORRECT WIDTH OF LL TRENCHES? _-' N <br /> CORRECT LENGTH OF LL TRENCHES? N <br /> CORRECT TYPE OF PIPING? N <br /> OTHER Y N <br /> SEEPAGE PITS: <br /> DISTANCE TO PROPERTY LINE? t Sd r N <br /> DISTANCE TO ANY WATER WELLS? N <br /> DISTANCE TO NEAREST FOUNDATION? <a 'T Y N <br /> DISTANCE OF SOIL BARRIER TO PITS? (pT 1 3 -112� N <br /> CORRECT DEPTH AND TYPE OF ROCK? Z S --a N <br /> CORRECT WIDTH? 3(0" 10 N <br /> OTHER Y N <br /> MISCELLANEOUS: <br /> DOES PERMIT DRAWING REFLECT ACCURATE LOCATION OF SYSTEM? l�% N <br /> DOES PERMIT DRAWING SHOW SUFFICIENT DETAIL TO LOCATE IN FUTURE? 10 N <br /> ANY NO ANSWER ABOVE REQUIRES PERMIT TO BE REDRAWN. /J <br /> COMMENTS: �e a,f cf�/7,6 L i.,�tv'' . . th.,..k ✓ 6fU,�C �titliYlaG ✓Jd`�'� <br /> f Q � Goy-�. :•c . <br /> INSPECTEDBY: DATE: <br />
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