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SR0082663
EnvironmentalHealth
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HORSE SHOE
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21301
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4200/4300 - Liquid Waste/Water Well Permits
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SR0082663
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Last modified
2/2/2021 4:56:16 PM
Creation date
2/2/2021 3:20:19 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0082663
PE
4211
FACILITY_NAME
21301 N HORSE SHOE CT
STREET_NUMBER
21301
Direction
N
STREET_NAME
HORSE SHOE
STREET_TYPE
CT
City
LODI
Zip
95227
APN
01931009
ENTERED_DATE
9/30/2020 12:00:00 AM
SITE_LOCATION
21301 N HORSE SHOE CT
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\fgarciaruiz
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EHD - Public
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SEPTIC SYSTEM INSPECTION CHECK LIST <br /> ADDRESS: % PERMIT# 2 �, <br /> Check box ACTUAL MEETS SJC <br /> PARAMETER if inspected MEASUREMENT STANDARDS? COMMENTS <br /> SEPTIC TANK: <br /> CORRECT TANK CAPACITY? l �jN <br /> DISTANCE TO FOUNDATION? Y N <br /> DISTANCE TO PROPERTY LINE? Y N <br /> DISTANCE TO ANY WELLS? A 1 Y N <br /> TANK LEVEL AND ORIENTED CORRECTLY? Y N <br /> SANITARY TEES CORRECTLY INSTALLED? Y N <br /> CORRECT TYPE OF PIPING? 5 DIZ 2:5 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? �` 1 tl Y N <br /> DISTANCE TO NEAREST LEACH LINE? 1 N <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? N <br /> IS D-BOX LEVEL? O <br /> OTHER Y N <br /> LEACH FIELD: (LL=LEACH LINES) <br /> DISTANCE TO PROPERTY LINE? 2 Y N <br /> DISTANCE TO ANY WATER WELLS? Y N <br /> DISTANCE TO NEAREST FOUNDATION? 2:1' Y N <br /> DISTANCE OF SOIL BARRIER BETWEEN LUS? y $ \27), Y N <br /> CORRECT DEPTH OF LL TRENCHES? L4 A ,y\ Y N <br /> CORRECT DEPTH AND TYPE OF ROCK? Y N <br /> CORRECT WIDTH OF LL TRENCHES? � V1 Y N <br /> ' <br /> CORRECT LENGTH OF LL TRENCHES? Y N <br /> CORRECT TYPE OF PIPING? et� Y N <br /> OTHER Y N <br /> SEEPAGE PITS: <br /> DISTANCE TO PROPERTY LINE? I (J 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 I t 121w- <br /> CORRECT WIDTH? vyY 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 \:% <br /> ANY NO ANSWER ABOVE REQUIRES PERMIT TO BE REDRAWN. <br /> COMMENTS: <br /> INSPECTED BY. Vtk ' DATE. i U I I�I�0 ;> <br />
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