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SR0082772
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0082772
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Last modified
2/2/2021 4:13:13 PM
Creation date
2/2/2021 3:45:38 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0082772
PE
4211
STREET_NUMBER
27751
Direction
N
STREET_NAME
KENNEFICK
STREET_TYPE
RD
City
GALT
Zip
95693
APN
00522006
ENTERED_DATE
10/22/2020 12:00:00 AM
SITE_LOCATION
27751 N KENNEFICK 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: L PERMIT# .� Z <br /> Check box ACTUAL MEETS SJC <br /> PARAMETER if inspected MEASUREMENT STANDARDS? COMMENTS <br /> SEPTIC TANK: <br /> CORRECT TANK CAPACITY? 1 2DO LJ N <br /> DISTANCE TO FOUNDAIION? Y N <br /> DISTANCE TO PROPERTY LINE? () Y N <br /> DISTANCE TO ANY WELLS? r (�jd { Y N <br /> TANK LEVEL AND ORIENTED CORRECTLY? Y N <br /> SANITARY TEES CORRECTLY INSTALLED? N (,2 Gy G J2 I-C 4t, C r ✓�`j F/I�r, <br /> CORRECT TYPE OF PIPING? j j23�;- Y N �n 5 /IPgI <br /> TANK VENTED? N <br /> ANY TANK ABNORMALITIES NOTED? Y N <br /> OTHER Y N <br /> DISTRIBUTION BOX: <br /> DISTANCE FROM TANK? Z l N <br /> DISTANCE TO NEAREST LEACH LINE? (ill N <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? N <br /> IS D-BOX LEVEL? O N <br /> OTHER Y N <br /> LEACH FIELD: (LL=LEACH LINES) <br /> DISTANCE TO PROPERTY LINE? 00 Q N <br /> DISTANCE TO ANY WATER WELLS? ® N <br /> DISTANCE TO NEAREST FOUNDATION? V11 2'T q N <br /> DISTANCE OF SOIL BARRIER BETWEEN LL'S? t/ W 11" N <br /> CORRECT DEPTH OF LL TRENCHES? N <br /> CORRECT DEPTH AND TYPE OF ROCK? N l Z J Z t,mac Y\ Lu k . <br /> CORRECT WIDTH OF LL TRENCHES? N <br /> CORRECT LENGTH OF LL TRENCHES? N <br /> CORRECT TYPE OF PIPING? -_-Ip C N Ip,�f Gct� <br /> OTHER Y N <br /> SEEPAGE PITS: <br /> DISTANCE TO PROPERTY LINE? koo N <br /> DISTANCE TO ANY WATER WELLS? N <br /> DISTANCE TO NEAREST FOUNDATION? Cl 1-; FyN N <br /> DISTANCE OF SOIL BARRIER TO PITS? to, 10 <br /> 7 <br /> CORRECT DEPTH AND TYPE OF ROCK? �/ - + !+�� N I l 7 — Z , v\CJn L u f-0,Jc <br /> CORRECT WIDTH? ✓ F4- N <br /> OTHER Y N <br /> MISCELLANEOUS: <br /> DOES PERMIT DRAWING REFLECT ACCURATE LOCATION OF SYSTEM? Y <br /> DOES PERMIT DRAWING SHOW SUFFICIENT DETAIL TO LOCATE IN FUTURE? Y SN <br /> ANY NO ANSWER ABOVE REQUIRES PERMIT TO BE REDRAWN. <br /> COMMENTS: <br /> INSPECTED BY: �u I•t Vic'C DATE: 2 pZ f zo-zo <br />
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