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SR0082789
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0082789
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Last modified
3/2/2021 2:42:27 PM
Creation date
3/2/2021 2:37:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0082789
PE
4210
FACILITY_NAME
7280 E KETTLEMAN LANE
STREET_NUMBER
7280
Direction
E
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
06113302
ENTERED_DATE
10/27/2020 12:00:00 AM
SITE_LOCATION
7280 E KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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SEPTIC SYSTEM INSPECTION CHECK LIST <br /> ADDRESS: p,,,` PERMIT# p$a <br /> Check box ACTUAL MEETS SJC <br /> PARAMETER if inspected MEASUREMENT STANDARDS? COMMENTS <br /> SEPTIC TANK: <br /> CORRECT TANK CAPACITY? l N <br /> DISTANCE TO FOUNDATION? YN <br /> DISTANCE TO PROPERTY LINE? ti oZ Y N <br /> DISTANCE TO ANY WELLS? Y N <br /> TANK LEVEL AND ORIENTED CORRECTLY? N <br /> SANITARY TEES CORRECTLY INSTALLED? (D N <br /> CORRECT TYPE OF PIPING? !�� �j N <br /> TANK VENTED? N <br /> ANY TANK ABNORMALITIES NOTED? Y N <br /> OTHER Y N <br /> DISTRIBUTION BOX: <br /> DISTANCE FROM TANK? -F4 Q DY N <br /> DISTANCE TO NEAREST LEACH LINE? , 44Y N <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? N <br /> IS D-BOX LEVEL? Y N <br /> OTHER Y N <br /> LEACH FIELD: (LL=LEACH LINES) <br /> DISTANCE TO PROPERTY LINE? �- S -�-� Y N <br /> DISTANCE TO ANY WATER WELLS? o Y N <br /> DISTANCE TO NEAREST FOUNDATION? (d -( Y N <br /> DISTANCE OF SOIL BARRIER BETWEEN LUS? t J Q' J N <br /> CORRECT DEPTH OF LL TRENCHES? y 2 - 5 j yl Y N DEQ✓per V <br /> CORRECT DEPTH AND TYPE OF ROCK? (aY N _ 2 , S ; ►�- ✓O LICA <br /> CORRECT WIDTH OF LL TRENCHES? Y N <br /> CORRECT LENGTH OF LL TRENCHES? -{-r ( (13 N <br /> CORRECT TYPE OF PIPING? l) N <br /> OTHER Y N <br /> SEEPAGE PITS: ( <br /> DISTANCE TO PROPERTY LINE? N <br /> DISTANCE TO ANY WATER WELLS? Y N <br /> DISTANCE TO NEAREST FOUNDATION? us) N <br /> DISTANCE OF SOIL BARRIER TO PITS? Y N <br /> CORRECT DEPTH AND TYPE OF ROCK? L— a a S'Sof N 2•S i h , r-,0 LK <br /> CORRECT WIDTH? ti K-n N <br /> OTHER Y N <br /> MISCELLANEOUS: <br /> DOES PERMIT DRAWING REFLECT ACCURATE LOCATION OF SYSTEM? OY <br /> N <br /> DOES PERMIT DRAWING SHOW SUFFICIENT DETAIL TO LOCATE IN FUTURE? N <br /> ANY NO ANSWER ABOVE REQUIRES P RMIT TO BE EDRAWN. <br /> COMMENTS: Q CL G !/{/p� u let <br /> INSPECTED B DATE: <br /> i � � �� <br />
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