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SR0082597
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0082597
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Last modified
12/28/2020 11:46:54 AM
Creation date
12/28/2020 11:46:07 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0082597
PE
4210
STREET_NUMBER
9703
Direction
E
STREET_NAME
COLLIER
STREET_TYPE
RD
City
ACAMPO
Zip
95220
APN
00709006
ENTERED_DATE
9/15/2020 12:00:00 AM
SITE_LOCATION
9703 E COLLIER RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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SEPTIC SYSTEM INSPECTION CHECK LIST <br /> ADDRESS: D f Q,+.- PERMIT# <br /> Check box ACTUAL MEETS SJC <br /> PARAMETER if inspected MEASUREMENT STANDARDS? COMMENTS <br /> SEPTIC TANK: Ex i t n <br /> CORRECT TANK CAPACITY) C� 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? Q N <br /> CORRECT TYPE OF PIPING? �� Gj� 35 0 N <br /> TANK VENTED? Y N <br /> ANY TANK ABNORMALITIES NOTED? Y N <br /> OTHER Y N <br /> DISTRIBUTION BOX: <br /> DISTANCE FROM TANK? 20 -F� Y N <br /> DISTANCE TO NEAREST LEACH LINE? �� !' ,F f /LW C 9 N <br /> Covtre(. o l <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? — ti/,e„�p ; fr ,Y N V <br /> IS D-BOX LEVEL? N <br /> OTHER Y N <br /> LEACH FIELD: (LL=LEACH LINES) ( <br /> DISTANCE TO PROPERTY LINE? �� D[� �'T Y N <br /> DISTANCE TO ANY WATER WELLS? S N <br /> DISTANCE TO NEAREST FOUNDATION? Y N 14S <br /> DISTANCE OF SOIL BARRIER BETWEEN LL'S? .✓ Y N <br /> CORRECT DEPTH OF LL TRENCHES? q - D i 0.' Y N <br /> CORRECT DEPTH AND TYPE OF ROCK? v ; vi, N <br /> CORRECT WIDTH OF LL TRENCHES? Lt � V, Y N <br /> CORRECT LENGTH OF LL TRENCHES? Y N <br /> CORRECT TYPE OF PIPING? 2 Y N <br /> OTHER Y N <br /> SEEPAGE PITS: \/ 7 l a a f"4Y N <br /> DISTANCE TO PROPERTY LINE? l <br /> DISTANCE TO ANY WATER WELLS? t (p D N <br /> DISTANCE TO NEAREST FOUNDATION? V/ l S Cj) N <br /> DISTANCE OF SOIL BARRIER TO PITS? Y N <br /> CORRECT DEPTH AND TYPE OF ROCK? 2 ,f 2 .f N <br /> CORRECT WIDTH? 6 H, 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: 'C p ></- <br /> c <br /> / ?,4( <br /> {� C r L /a r<i✓Yr 2 —1 <br /> /tern fl L i <br /> INSPECTED BY:� j n 1 DATE: 1 _zo 7_0 <br />
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