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SR0083095
EnvironmentalHealth
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19152
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4200/4300 - Liquid Waste/Water Well Permits
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SR0083095
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Entry Properties
Last modified
4/2/2021 9:22:30 AM
Creation date
4/2/2021 9:09:32 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0083095
PE
4211
STREET_NUMBER
19152
Direction
S
STREET_NAME
SANTA FE
STREET_TYPE
RD
City
ESCALON
Zip
95320
APN
22736013
ENTERED_DATE
12/31/2020 12:00:00 AM
SITE_LOCATION
19152 S SANTA FE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\tsok
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EHD - Public
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SEPTIC SYSTEM INSPECTION CHECK LIST <br /> ADDRESS: PERMIT# <br /> Check box ACTUAL MEETS SJC <br /> PARAMETER if inspected MEASUREMENT STANDARDS? COMMENTS <br /> SEPTIC TANK: <br /> CORRECT TANK CAPACITY? <br /> DISTANCE TO FOUNDATION? 10' ® N <br /> DISTANCE TO PROPERTY LINE? N <br /> DISTANCE TO ANY WELLS? le) N <br /> TANK LEVEL AND ORIENTED CORRECTLY? N <br /> SANITARY TEES CORRECTLY INSTALLED? N <br /> CORRECT TYPE OF PIPING? -S N <br /> TANK VENTED? N <br /> ANY TANK ABNORMALITIES NOTED? ,1 O (� N <br /> OTHER Y N <br /> DISTRIBUTION BOX: <br /> DISTANCE FROM TANK? \l N <br /> DISTANCE TO NEAREST LEACH LINE? Cj N <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? N <br /> IS D-BOX LEVEL? N <br /> OTHER Y N <br /> LEACH FIELD: (LL=LEACH LINES) f <br /> DISTANCE TO PROPERTY LINE? ca 6 N <br /> DISTANCE TO ANY WATER WELLS? N <br /> DISTANCE TO NEAREST FOUNDATION? \IS,' N <br /> DISTANCE OF SOIL BARRIER BETWEEN LUS? W) N <br /> CORRECT DEPTH OF LL TRENCHES? N <br /> CORRECT DEPTH AND TYPE OF ROCK? \p,' \-\�h c�Str�h N <br /> CORRECT WIDTH OF LL TRENCHES? Z"\ N <br /> CORRECT LENGTH OF LL TRENCHES? a0' N <br /> CORRECT TYPE OF PIPING? N <br /> OTHER 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? Y N <br /> DISTANCE OF SOIL BARRIER TO PITS? Y N <br /> CORRECT DEPTH AND TYPE OF ROCK? Y N <br /> CORRECT WIDTH? Y 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 /> E kz)fl <br /> F <br /> INSPECTED BY: n Q� DATE: <br />
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