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SR0082108
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0082108
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Last modified
3/2/2021 2:10:26 PM
Creation date
3/2/2021 1:59:05 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0082108
PE
4210
STREET_NUMBER
24211
Direction
N
STREET_NAME
ELLIOTT
STREET_TYPE
RD
City
ACAMPO
Zip
95220
APN
00740059
ENTERED_DATE
5/21/2020 12:00:00 AM
SITE_LOCATION
24211 N ELLIOTT 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: uL�� F,i l L i , PERMIT# <br /> Check box ACTUAL MEETS SJC <br /> PARAMETER if inspected MEASUREMENT STANDARDS? COMMENTS <br /> SEPTIC TANK: <br /> CORRECT TANK CAPACITY? N <br /> DISTANCE TO FOUNDATION? f Ll(� N <br /> DISTANCE TO PROPERTY LINE? I C� N <br /> DISTANCE TO ANY WELLS? N <br /> TANK LEVEL AND ORIENTED CORRECTLY? ��i7 N <br /> SANITARY TEES CORRECTLY INSTALLED? N <br /> CORRECT TYPE OF PIPING? �Fh r,9 ?�5 N <br /> TANK VENTED? y 4 N <br /> ANY TANK ABNORMALITIES NOTED? N <br /> OTHER Y N <br /> DISTRIBUTION BOX: <br /> DISTANCE FROM TANK? 1 N <br /> DISTANCE TO NEAREST LEACH LINE? (a° Q{ N <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? yet 7 g) N <br /> IS D-BOX LEVEL? t N <br /> OTHER Y N <br /> LEACH FIELD: (LL=LEACH LINES) <br /> DISTANCE TO PROPERTY LINE? sN <br /> DISTANCE TO ANY WATER WELLS? 0n N <br /> DISTANCE TO NEAREST FOUNDATION? N <br /> DISTANCE OF SOIL BARRIER BETWEEN LL'S? N <br /> CORRECT DEPTH OF LL TRENCHES? ���y 1��" N <br /> CORRECT DEPTH AND TYPE OF ROCK? N fat�U1 Q !i. <br /> CORRECT WIDTH OF LL TRENCHES? Lei, N <br /> CORRECT LENGTH OF LL TRENCHES? N <br /> CORRECT TYPE OF PIPING? �Y�, N Q F bA A-l� 9 iJC L <br /> OTHER Y N <br /> SEEPAGE PITS: <br /> DISTANCE TO PROPERTY LINE? Z\ Y N <br /> DISTANCE TO ANY WATER WELLS? Y N <br /> DISTANCE TO NEAREST FOUNDATION? (p p` Y N <br /> DISTANCE OF SOIL BARRIER TO PITS? t Y N <br /> CORRECT DEPTH AND TYPE OF ROCK? N � <br /> CORRECT WIDTH? ^�\,h © 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: <br /> /"/ L c <br /> INSPECTED BY: DATE: <br /> � <br />
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