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SR0082429
EnvironmentalHealth
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23627
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4200/4300 - Liquid Waste/Water Well Permits
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SR0082429
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Entry Properties
Last modified
12/31/2020 8:37:20 AM
Creation date
12/31/2020 8:22:46 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0082429
PE
4215
STREET_NUMBER
23627
Direction
N
STREET_NAME
DE VRIES
STREET_TYPE
RD
City
LODI
Zip
95242
APN
00304003
ENTERED_DATE
8/6/2020 12:00:00 AM
SITE_LOCATION
23627 N DE VRIES RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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Tags
EHD - Public
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SEPTIC SYSTEM INSPECTION CHECK LIST <br /> ADDRESS: 3 6 a e PERMIT# Q y 2 <br /> Check box ACTUAL MEETS SJC <br /> PARAMETER if inspected MEASUREMENT STANDARDS? COMMENTS <br /> SEPTIC TANK: (,,ice JJ L <br /> CORRECT TANK CAPACITY? 120Q a �lf <br /> Y N 2oO0 qaI <br /> DISTANCE TO FOUNDATION? f o �y � N �g F .Fpr S.T 'l <br /> DISTANCE TO PROPERTY LINE? (D N <br /> DISTANCE TO ANY WELLS? 2.2 Z r ST© N <br /> TANK LEVEL AND ORIENTED CORRECTLY? Y N <br /> SANITARY TEES CORRECTLY INSTALLED? Y N <br /> CORRECT TYPE OF PIPING? rjL�� S (L 3S C:Yl N <br /> TANK VENTED? 0 N S T, in i 0.( �Y <br /> ANY TANK ABNORMALITIES NOTED? Y N <br /> OTHER (/ S Y N <br /> DISTRIBUTION BOX: <br /> DISTANCE FROM TANK? ^-a N <br /> DISTANCE TO NEAREST LEACH LINE? N <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? N <br /> IS D-BOX LEVEL? N <br /> OTHER Y N <br /> LEACH FIELD: (LL=LEACH LINES) !x 3 <br /> DISTANCE TO PROPERTY LINE? ( \/ -> L OD �� V N <br /> DISTANCE TO ANY WATER WELLS? �� Y N <br /> DISTANCE TO NEAREST FOUNDATION? N <br /> DISTANCE OF SOIL BARRIER BETWEEN LUS? N <br /> CORRECT DEPTH OF LL TRENCHES? L-t H.Y N <br /> CORRECT DEPTH AND TYPE OF ROCK? Y N <br /> CORRECT WIDTH OF LL TRENCHES? \/ ( w 1 (2D N <br /> CORRECT LENGTH OF LL TRENCHES? v-+ Q N <br /> CORRECT TYPE OF PIPING? oY N <br /> OTHER vY N <br /> SEEPAGE PITS: <br /> O <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? N <br /> ANY NO ANSWER ABOVE REQUIRES PERMIT/_TO BE REDRAWN. <br /> COMMENTS: /Z p�'c� Tj (�l� L/PtQ-- Q // e,,V7 L <br /> eal <br /> hr( O 117 <br /> INSPECTED BY:,--D /� /2J //„ t DATE: T <br />
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