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SR0082805
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4200/4300 - Liquid Waste/Water Well Permits
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SR0082805
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Last modified
3/2/2021 2:09:05 PM
Creation date
3/2/2021 2:02:34 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0082805
PE
4214
STREET_NUMBER
5006
Direction
N
STREET_NAME
ARCHERDALE
STREET_TYPE
RD
City
LINDEN
Zip
95236
APN
09113007
ENTERED_DATE
10/30/2020 12:00:00 AM
SITE_LOCATION
5006 N ARCHERDALE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\tsok
Tags
EHD - Public
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SEPTIC SYSTEM INSPECTION CHECK LIST <br /> ADDRESS: Q�Q-O�-,-�;-- PERMIT# 5� <br /> Check box ACTUAL MEETS SJC <br /> PARAMETER if inspected MEASUREMENT STANDARDS? COMMENTS <br /> SEPTIC TANK: <br /> CORRECT TANK CAPACITY? Y N <br /> DISTANCE TO FOUNDATION? Y N <br /> DISTANCE TO PROPERTY LINE? 7 A� Y N <br /> DISTANCE TO ANY WELLS? (fl�' Y N <br /> TANK LEVEL AND ORIENTED CORRECTLY? Y N <br /> SANITARY TEES CORRECTLY INSTALLED? �s Y N <br /> CORRECT TYPE OF PIPING? Y N <br /> TANK VENTED? Y N <br /> ANY TANK ABNORMALITIES NOTED? Y N <br /> OTHER e Y N <br /> DISTRIBUTION BOX: <br /> DISTANCE FROM TANK? Y N <br /> DISTANCE TO NEAREST LEACH LINE? gyp /�CT_ Y N <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? _� h Y N <br /> IS D-BOX LEVEL? v\���, Y N <br /> OTHER l V Y N <br /> LEACH FIELD: (LL=LEACH LINES) <br /> DISTANCE TO PROPERTY LINE? 1`y Y N <br /> DISTANCE TO ANY WATER WELLS? Y N <br /> DISTANCE TO NEAREST FOUNDATION? Y N <br /> DISTANCE OF SOIL BARRIER BETWEEN LUS? J j Y N <br /> CORRECT DEPTH OF LL TRENCHES? ��" Y N <br /> CORRECT DEPTH AND TYPE OF ROCK? Z° Y N i 1�rr t c VAR- �r, <br /> CORRECT WIDTH OF LL TRENCHES? fib" Y N <br /> CORRECT LENGTH OF LL TRENCHES? Y N <br /> CORRECT TYPE OF PIPING? ���. 1��j Y N <br /> OTHER _�1 ) Y N <br /> SEEPAGE PITS: <br /> DISTANCE TO PROPERTY LINE? Y N <br /> DISTANCE TO ANY WATER WELLS? Y N <br /> DISTANCE TO NEAREST FOUNDATION? —�I T— Y N <br /> DISTANCE OF SOIL BARRIER TO PITS? \ Y N <br /> CORRECT DEPTH AND TYPE OF ROCK? LS' \ tin Y N <br /> CORRECT WIDTH? Y N <br /> OTHER p` Y N <br /> MISCELLANEOUS: <br /> DOES PERMIT DRAWING REFLECT ACCURATE LOCATION OF SYSTEM? 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: d <br /> INSPECTED BY: DATE: <br /> l 1� 120 Z,o <br />
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