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SR0082946
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0082946
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Last modified
3/2/2021 2:10:21 PM
Creation date
3/2/2021 2:03:35 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0082946
PE
4210
FACILITY_NAME
12550 E COLLIER RD
STREET_NUMBER
12550
Direction
E
STREET_NAME
COLLIER
STREET_TYPE
RD
City
ACAMPO
Zip
95632
APN
00725076
ENTERED_DATE
12/1/2020 12:00:00 AM
SITE_LOCATION
12550 E COLLIER 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: `t— L " PERMIT# ,= K2, 2 ` <br /> Check box ACTUAL MEETS SJC <br /> PARAMETER if inspected MEASUREMENT STANDARDS? COMMENTS <br /> SEPTIC TANK: <br /> CORRECT TANK CAPACITY? Y N -4— <br /> DISTANCE <br /> 4 �' ,�� f ^r• �(�'1� K <br /> DISTANCE TO FOUNDATION? 3 Y N <br /> DISTANCE TO PROPERTY LINE? Y N <br /> DISTANCE TO ANY WELLS? Y N <br /> TANK LEVEL AND ORIENTED CORRECTLY? Y N <br /> SANITARY TEES CORRECTLY INSTALLED? Y N <br /> CORRECT TYPE OF PIPING? 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? 2S/ N <br /> DISTANCE TO NEAREST LEACH LINE? 5 Z Y N <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? N <br /> IS D-BOX LEVEL? S N <br /> OTHER Y N <br /> LEACH FIELD: (LL=LEACH LINES) <br /> DISTANCE TO PROPERTY LINE? Y N <br /> DISTANCE TO ANY WATER WELLS? N <br /> DISTANCE TO NEAREST FOUNDATION? Y N <br /> DISTANCE OF SOIL BARRIER BETWEEN-L'S? Y N <br /> CORRECT DEPTH OF LL TRENCHES? N <br /> CORRECT DEPTH AND TYPE OF ROCK? Y N �i►gR� �j/ Fp S 1,, f C+r( <br /> CORRECT WIDTH OF LL TRENCHES? Y N <br /> CORRECT LENGTH OF LL TRENCHES? Y N <br /> CORRECT TYPE OF PIPING? ('�35 N <br /> OTHER Y N <br /> SEEPAGE PITS: <br /> DISTANCE TO PROPERTY LINE? Y N <br /> DISTANCE TO ANY WATER WELLS? U N <br /> DISTANCE TO NEAREST FOUNDATION? Y N <br /> DISTANCE OF SOIL BARRIER TO PITS? Y N <br /> CORRECT DEPTH AND TYPE OF ROCK? Z S/Z/ '9 N <br /> CORRECT WIDTH? 3; it/ (22 N <br /> OTHER Y N <br /> MISCELLANEOUS: <br /> DOES PERMIT DRAWING REFLECT ACCURATE LOCATION OF SYSTEM? Ute N <br /> DOES PERMIT DRAWING SHOW SUFFICIENT DETAIL TO LOCATE IN FUTURE? N <br /> ANY NO ANSWER ABOVE REQUIRES PERMIT TO BE REDRAWN. ee LL /� l LJ / <br /> COMMENTS: r/1/► c� Te 2 <br /> INSPECTED BY: 2710 h,&,, <br /> 5 `1 _r/` DATE: /�/'n,�0 <br />
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